Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my daughter is 2and half year old.she is suffering from very severe cold &cough since 3months.we have met children specialist and he gave her cefidinir and cough syrup.but there is no change,and now bad smell comes out from her nose &mouth.what could we do now?please suggest any medicine for her. ### REPLY: Thanks for your question on . I can understand your concern. Better not to start any . She is having chronic cough and cold not improving with routine antibiotics. So we should definitely find out cause for this. So consult pediatrician and get done clinical examination of respiratory system and chest x-ray. Possibility of lung infection or allergic asthma is more likely in her case. She may need higher antibiotics and anti-allergic (montelukast)  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 are the side affects of a BCG Treatment for Kidney Cancer. My husband has had bladder cancer that is now in the kidneys. They inserted tubes thru the back directly into the kidneys. He had a treatment Thursday. He off and on gets really cold, and has a slight fever. 99.8. Should we be concerned. He had a runny nose and a slight cold after the treatment also. Otherwise he feels pretty good. ### REPLY: Hi, BCG given for bladder cancer has its own side effect. About 1 in 2 people have flu like symptoms for 24 to 48 hours after each treatment. You should tell about this to his treating doctor in your next appointment. There is also a very small chance that some TB could get into his system and give him TB symptoms such as fever, joint pain, vomiting cough, skin rashes. These effects only happens to fewer than 1 person in every 100 who has this treatment. It is important that you tell your doctor straight away if he has any of these symptoms or have a high temperature for more than 48 hours. He may need treatment with anti TB . Do consider positive feedback as a credit to my work. Let me know if you have any further questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 back is starting to feel better, after a few hours of waking. my bed is 40 yrs old, and i realize that could be causing alot of discomfort. i did hurt myself in gym (again) about 3-4 weeks ago. i believe i have a herniated disc.... could this also contribute to have a bloody stool also? ### REPLY: Hello! Welcome to Ask a Doctor service! I understand your concern and would explain that blood stool is not related to the back pain or any herniated disk. For this reason, I would recommend consulting with your attending physician for a physical exam and a fibro-colonoscopy. Regarding the back pain, I would recommend performing a lumbar X-ray study and changing your bed, in order to sleep better. Hope to have been 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: kidney cancer my dad has a tumor in his kidney and fluid around his spleen and thickenning of the fat cell. we are waiting on results from petscan. doc told us he most likely has kidney cancer. but lately he has been weak, nauseated, taking 4 naps a day, had a fever, and has pain in his right side. to me that all indicates something additional bc the symptoms are more than what kidney cancer says. what are those symptoms sometimes to? ### REPLY: helloThanks for query. Based on the Ultrasound Scan findings that you have posted I would state that your father has Cancer of kidney which has penetrated through capsule of the kidney and infiltrated in to perinephric fat with reactionary fluid being formed around spleen. The other symptoms like fever, pain in Rt side of abdomen, weakness etc. are due to generalized debility associated with cancer of kidney and do occur like with cancer of any organ. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On my left side of my mouth above my second molar there is a bump about the size of a pea that is very sensitive to pressure. When I press on the bump if feels as if I m trying to pull out my molar. Any idea what this bump could be. About 5 years ago I had a filling done on this tooth. There is no pain coming from the tooth though. Only pain from the pressure of the bump. It s getting to the point now that when I m eating occasionally it will bother me. ### REPLY: The bump in that region suggests that you are having an infection below that filling that you got five years back which is spreading to the roots and forming pus there. Usually this can arise when the decay spreads below the filling, and we call it secondary caries. Though it's not bothering you much now I would suggest you to get an x-ray of that region that would clarify it, and then you would require a re-filling with a root canal treatment. Don't be deceived by the painless nature of it as it may grow any time and get it treated as soon as possible. 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 m 41 years old male with weight 105 kgs.and 185 cms in height. my chest remains heavy most of times. sometimes pain in both shoulders. i play tennis regularly and walk for 5 kms. got TMT done which is negative. i smoke 5 to 7 ciggrettes a day. my blood chemistry is normal. cholestrol and sugar level are normal. i take a tablet nodon h for bp. my bp shootes to 140-100 sometimes if i dont take tablet. what can be my problem?? ### REPLY: Hi welcome to  ..... Here most noticeable factor seems to lead high blood pressure is dear your smoking habit..... Smoking can lead endothelial damage, vasoconstriction, free radical formation all lead predisposition for hypertension and thrombosis.... Smoking in addition release elastane which damage elastic tissue of lung and can lead chronic obstructive lung disease or fibrosis alveolars like restrictive disease. Chest x-ray and spirometry done for it... So gradually decrease frequency and stop smoking. Antihypertensive medicine taken regularly... Avoid stress.... Continue daily exercise. More fruits and green leafy veg useful. Also investigate with ECG if chest pain associated with radiation to arm or neck. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my 6 year old daughter has had fevers since sunday morning giving her nurophen and panadol to get temp down. the temp has eased last night but she woke with a vomiting twice throughout the night seems a bit better today but still a headache and the temp comes back when the nurofen runs out? ### REPLY: Hi... Thank you for consulting in . Fever of few days without any localizing signs could as well a viral illness. Usually rather than fever, what is more important is the activity of the child, in between 2 fever episodes on the same day. If the kid is active and playing around when there is no fever, it is probably viral illness and it doesn't require antibiotics at all. Once viral fever comes it will there for 4-7 days. So do not worry about duration if the kid is active. Paracetamol can be given in the dose of 15 mg/kg/dose (maximum ceiling dose of 500 mg) every 4-6th hourly that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. Hope my answer was helpful for you. I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son 19 month old is passing stool after meals. the stool consistency is neither formed nor watery nor pasty, colour is yellowish. he passes 3-4 times a day since last three days. no foul smell, no abd. pain.its little sticky and only once there was little mucus i am unable to understandant if it is a giardis infection or anyother ### REPLY: Hi... Thank you for consulting in . What your kid is having is not a diarrhea and is only a gastronomic reflux. It is quite common for babies of this age group t pass small amount of diarrhea or loose stools soon after feeds. This need not be treated as diarrhea and especially antibiotics are not indicated. Unless the kids having low urine output or very dull or excessively sleepy or blood in motion or green bilious vomiting...you need not worry. Hope my answer was helpful for you.  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My 4 year old son has a cracked lip, a red blotchy rash from ankles to his feet and it goes up his leg. The rash is also around his wrists. He doesn t have a fever. The rash is not raised nor is it hot. The rash does not itch. We gave 1 tsp of benadryl and rash is still there. ### REPLY: Hi... I feel by what you quote he should be having a - Hand Foot Mouth disease. This is one viral illness among all other anthems which can cause fever followed by rash over palms and soles. It is a self-limiting disorder and itching can be really worrisome. I suggest you use any over the counter antihistamine if you have one with you now. You can use HY .  This can even cause some peeling of skin in the next 4-6 weeks and do not worry about it. 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 cellulitis staph infection and keep my place covered. A coworker found out what I had and went crazy even though my doctor wrote a note saying I was not contagious. The coworker says my doctor does know what she is talking about. Can that be true? ### REPLY: Hello, THX to contact us. I understand your concern. If I am your treating doctor I advise you that it is not much contagious. In other words it is not as contagious as other disease like swine flu. If you come in contact with the lesion having high bacterial load of the staphylococcus bacteria than it is possible to have this infection. But it can be stopped spreading by taking due care that is proper handwashing, using sanitizer, using proper disinfectants etc. I will be happy to answer more of your concerns, kindly know me, Wish you a very good health at . . Infectious Disease. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I think I have sone kind vaginal infection, for the last few months I ve been starting to itch really bad on my inner thighs to my vaginal area I have no self control and itch it till my skin breaks and clear puss come thrwe, my color has changed down their to a darker skin color and now I m starting to notice a bad order, how can I get my skin back to a light color and stop all this itching or is it too late am I scarred, will the order go away? ### REPLY: Thanks for your question. I think you have a condition known as vulvuvaginitis which is an inflammation of the vulva and the vagina. This is usually infectious in origin and caused by germs like fungi and bacteria. There are many types of infectious agents which can be at the origin of such a condition. Your condition therefore requires a consultation with a gynecologist, so a proper physical examination is done, and laboratory tests prescribed and proper medications prescribed. I would also advise you go for consultation with your sex partners as most at times these are sexually transmissible infections and both partners have to be treated. I wish you best of luck and good health. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi From about one and a half months I have been facing abdominal discomfort like gas/pressure is accumulating just under neath my diaphragm.  I got a positive ascaris lumbricoides unfertilized egg in my stool test. My chest xray, abdomen erect xray,  abdomen ultrasound, cbc blood test were all normal.  I took albendazole 4 tablets for the Worms.  In addition I was prescribed aristogym syrup, bifilac capsule, sompraz capsules for ten days.  Prior to stool test I took parit tablets and ganaton tablets for two weeks. Right now I still have abdominal discomfort and pressure and it increases a bit after eating, I also feel a little burning  after food especially spicy food.  Can you suggest me next course of action, whether endoscopy is a must and if a barium meal xray would be of any help. Thanks and regards Pranay Gupta ### REPLY: Hi welcome to  forum.  Thanks for calling . Forum.  You had upper abdominal pain, Not responding to medicines. It appears to be due to gastric irritation due to peptic ulcer, or irritant diet. It also may be due to gall bladder problem. It may also be due to lactose intolerance.  I advise you to consult a gastroenterologist for diagnosis and treatment. You may need to go for M.R.I., gastrostomy, besides other routine tests for confirmation.  I advise you to avoid spices, junk foods, or oily foods, to avoid gastric irritation. Take only junk foods, like bread, curd, etc. Wishing for a quick and complete recovery.  Best regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been having some trouble with capalaries(spelling) in the my right eye bursting - twice in the past two weeks - blood pressure seems to be ok when I take it. How to treat they eye tonight until I can get to the doctor in the morning. Can it be caused by sinus problems? THANK YOU SO VERY MUCH FOR YOUR RESPONSE. ### REPLY: Hello, thank you for your contact to . I understand your concern. If I am your treating doctor I suggest you that such a problem is common with sinus infection. At home treatment is not possible with home remedy. If available than I start with ciprofloxacin .  But article treatment requires sinus treatment. If you have anything else to ask kindly contact me.  Infectious Disease specialist. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My girlfriend has been on this pill (birth control) for over a year. This month, she has forgotten to take her daily pill a few times and has taken 3 in one day to make up for what she forgot to take. She stopped taking it last week ready for her period which should have started yesterday. We have never had sex, but we have had sexual contact through masturbating each other, but every time I have ejaculated, we stop contact immediately and wash hands. Could she be pregnant? ### REPLY: Hello dear, I understand your concern. In my opinion pregnancy usually results when semen is ejaculated inside or around the vagina during the fertile period. But just masturbation will not result in pregnancy. Birth control pills are effective of all contraception methods to prevent unwanted pregnancy if they are taken regularly. But as the true intercourse did not occur even the irregular intake might not result in pregnancy. So relax. There is no chance of pregnancy. When one pill is missed two pills are taken in the next day. When two pills are missed continuously then two pills each are taken on two successive days. When three pills are missed in a row the birth control pills might not work for that cycle and other method like condom should be used as back up. Anyways as nothing as true intercourse was done there is no chance of pregnancy. Hope this helps. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Lately Ive been getting strange symptoms when I eat.A few days ago I had a sharp stabbing pain in my chest after eating, my left arm went a little numb and after the pain subsided (15 minutes or so) I had the sweats and nausea for a few hours after. My arm also felt odd the rest of the night. From that point on, any time I eat anything I start burping quite a lot, and sometimes my left arm feels numb.Im 22 years old, 256 pounds, 6 feet 1 inch tall.I had an EKG about a week and a half ago, before all this and the doctor told me it came back perfect. Absolutely perfect. Not sure what to do now though. Could it be a heart related thing? Should I go back to my doctor? ### REPLY: Thanks for your question on . I can understand your concern. No need to worry about heart diseases as you are too young (22 years) and having normal ECG recently. In my opinion, you are mostly having stress and anxiety related HERD (gastroesophageal reflux disease) because you are having chest pain and burping immediately after eating.  HERD is due to laxity of gastroesophageal sphincter. Because of this the acid of the stomach tends to come up in the esophagus and cause symptoms of chest pain, burping etc. So follow these steps for better symptomatic relief. 1. Avoid hot and spicy food. 2. Avoid stress and tension, be relaxed and calm. 3. Avoid large meals, instead take frequent small meals. Avoid junk food. 4. Take pantoprazole tablet on empty stomach. 5. Quit smoking and Alcohol if you have these habits. 6. Go for walking after meals. 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: hi I am a 37 year old female. For the last almost 2 years I have been suffering light headiness, dizziness and excessive burping. The other day I was just sitting on the couch with my daughter watching tv and my head started spinning like the whole room was turning I tried to lay down and close my eyes but this did not help.I had to go in the basement because I was sweating like crazy and then I started belching this lasted for like 30 min until I finally threw up 3 times. I was so scared I felt like I was going to die, my heart was beating like crazy.It has been 4 days since and I am still very weak and light headiness. I have gone through every possible test. ### REPLY: Hello, Your symptoms are episodic and involve giddiness with nausea and vomiting. Do you have any problems with hearing or any ringing sound in ears? If so you are likely to be suffering from Deniers disease. You need to get evaluated by ENT surgeon for ruling out any external ear problems. Following that some tests like audiometry etc. are required. Sometimes migraine may present with such symptoms without any headache. After ENT evaluation you need to consult a neurologist. 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: Have had mri done.. At l1-2 there is minimal circumferential disc bulge At l2_2 disc bulge with small superimposed central dick herniation and 2mm retrolisthesis of l2 on l3 disc slightly indents ventral the Cal sacred At l3-4 minimal circumferential disc bulge At l4-5 disc desiccation and small marginal osteophyte and 2mm retrolisthesis of l4 on l5. L4-5 central disc herniation with annular tear. Disc impinge the Cal save mild central canal and mild to moderate bilateral lateral recess stones is and borderline bilateral neural faraminal stenosis. At l5-s1 minimal circumferential disc bulge with mild right sided facet artrosis. Have leg weakness and right leg wants to drag..seen workman s comp orthopedist and he feels there nothing wrong with me ### REPLY: Hi there. Usually MRI scans pick up even minor amounts of disc herniation which will be present in almost everybody. It is mainly the disc herniation which impinge on the spinal cord or its nerve roots which can cause a problem. If there is a definite weakness your right leg and radiating pain associated with it that could be an indication for you to undergo surgery. From your report I would be worried about the L4-5 disc levels which is causing moderate stenosis of your lateral recess. Sometimes with stenosis another problem that can occur is a dull cramping pain that can occur on the affected leg. So kindly get your neurology evaluated if your symptoms persists and if you notice a definite decrease in your walking distance, radiating or cramping pain or weakness. Consult a spine surgeon. Also know that if at all you might need any operation, it is going to take care of your leg pain. Your back pain may or may not get relieved. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 19 years old I hv pain in my testicles during strong erection also I feel pain wen I go through gas trouble.... I went through scanning before 3 months doctor told I am going through anxiety...... plz help me!!! I was mastrubating a lot and now I hv controlled myself but not fully..... wt should I do control mastrubating ### REPLY: Hi, Thanks for posting your query. Masturbation is NT a bad activity BT in excess it really causes harm u probably lose your energy every time n u cudnt concentrate. If u real want to stop it the u shut b determinant to it try to engage ourself in sum other activities more like reading or get engage with your studies or career. Try to make ourself busy as much as possible THT is d only way to control it Bros being lonely makes u think in masturbation only. 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: had a period and a week later I had light red spotting..days befor my period i took a preg test and had two lines one light and another kinda dark. also had some cramping with the spotting..what could it be and i shuld went to the gyn dr had a pap and she said all looks good..it was my physcal. period started Sept. 28, ended on the 30...spotted on Oct.5 ### REPLY: Hallow Dear, The spotting you had on 5 Oct could be labelled as mittlesmersch which happens at the time of egg release. It is also associated with some colicky pain in the abdomen. So I would not have any concern for this spotting. However, your pregnancy test needs some attention. It was weak positive. After your normal menses, such weak positive pregnancy test is rather mystery. Such week positive pregnancy test is due to low levels of ; which happens after baby becomes non-viable, abortion or ectopic pregnancy. However, your history is suggestive of none of these conditions. Please repeat the test again after about a weeks gap. If still it is positive or weak positive, report to the Gynecologist. Hope this helps you, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my son had been diagnosed with mono even though multiple blood test were negative. he has blisters in mouth and swollen lymph nodes in neck. all other symptoms such as vomiting, head aches, fatigue and loss of apatite have went away. it has been 10 days since first symptoms began. could this may have just been the flew. also consider that his liver enzymes were slightly elevated 7 days from today during wich blood test were administered. ### REPLY: Hi, dear I have gone through your question. I can understand your concern. He has some viral infection or flu.  It leads to fever, fatigue, headache, vomiting and elevated liver enzymes.  All symptoms are common in viral infection.  Nothing to worry about that.  Just .  Your liver enzymes will come back to normal within few days. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I suffer with cold hands and feet, constant chest infections and sinus infections. I keep fit but now weeze after my workout, although it dosent affect my breathing whilst excercising. My doctor has put me on a course with a cenil modulite steroid inhaler. I now have a fresh sinus and chest infection and this weakness is starting to depress me. Can I do anything else to clear this problem? ### REPLY: Hi welcome to the  You are having wheezing problem and breathlessness after exercise Your work up done as follows... -CBC -Auscultation -Spirometry to assess severity and guide proper treatment -EKG According to cause specific treatment given You have been prescribed proper treatment with steroid But if asthma present (diagnosed with spirometry) than better to prescribed albuterol like bronchodilator if needed Is CBC shows necrophilia than oral antibiotic course given So depending on your clinical generic specific treatment plan decided Take care Consult pulmonologist for examination and further work up ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Good Morning Doctor, My father is heart patient. Last week check the angiogram Test. In the report 1. LMCA - Normal, 2.LAD- Mid Segment 90% long segment stenosis, Distal another tight lesion graftable.3.LCX- Proximal 70% stenosis, Mid Segment 70% stenosis after OM1. 4. RCA-Dominet, Osteal 90% stenosis, Mid Segment 100% occlusion, NO antegrade flow, good retrograde. This is the report, what is your suggesion sir, ### REPLY: Hello, Thanks for posting your query on  ...* Brief Answer:it seems that your father needs to do CABG(coronary artery bypass grafting).*Explanation: My opinion is that multiple coronary vessel disease is an indication to do coronary bypass grafting, percutaneous coronary intervention in your father condition is debatable and may be non-beneficial to his condition, on the other hand, CABG would improve morbidity and mortality. I suggest my patients the following : consult a cardiothoracic surgeon about your fathers condition and adhere to antiischemic medications information provided by you is not sufficient to provide a good opinion. If someone comes to me with this condition I would ask them about other comorbidities and results of any other investigations you have done to your father.*Conclusion: I suggest you consult a cardiothoracic surgeon and stick to your medications low salt in diet and If you have any further questions I will be happy to help, If not, you can close the discussion and rate the answer. Wish your father good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have an orbital blowout fracture from a horse accident, along with nasal an jaw fractures. When I went to the emergency room, they said the situation was severe; however, the fractures seemed to be aligned and might heal on their own. After a couple of bad consultations, I went to John Hopkins. They want to perform surgery asap along with ENT surgery. They also said that they usually do surgery two weeks after the injury. I am older and am having a lot of pain and paralysis, but I m concerned about the major surgery on my face. What are my options? ### REPLY: Hello, I can understand your concern. Paralysis and extreme pain are expected after multiple fractures including your nose, orbit and jaw. However, surgery might be necessary because all fragments of all bones cannot be aligned perfectly without opening the bony structure of the face and aligning the bones with each other. After aligning, they must use plates, screws or wires to maintain their correct position and heal the fracture sites which might not be possible without surgery. Maxillofacial surgeries in accident cases provide good results and as ENT surgeon will be present during the surgery, the nasal bones will be put in correct position by the specialist of nose. Thus, I would advise you to go for surgery as soon as possible to avoid misalignment of the fractured bones and their healing in the wrong way. I hope this information helps you. Thank you for choosing . I wish you speedy recovery! Best, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ok I m 17 years old never had any health problems but just curious about cancer; should I worry about it in my life. I mean I ve never had members in my family that had it except for my great uncle that had prostate but he was 70. It just worries me and last thing can I have annual physicals each year to make sure my health is good ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You should not worry about cancer.  You have average chance.  Furthermore, you are physically fit with no family history of cancer.  So chances are very low.  However, certain cancers are due to genetic mutation, and you can not prevent all. But chances are negligible and not worrisome. Just go for annual health check up. And don't worry about cancer. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have 4 ofmy leftback mollers broken and infected. They have been lije this at leadt one year, im having chest pain an have been for about 6 to 9 months. Couldthese be associated. Also i woke up yrsterday chiking barely able tobreath couphing up nothing nmbut it gleared whstever wad blocking my airway . Any advice,i have dental appointment tomarrow ### REPLY: Hi. Welcome to  . I have gone through your query and can understand your concerns. As per your complaint as you have infected molars and chest pain, although there is a direct co-relation between the infected teeth which can lead to infection through blood reaching the endocardium [inner layer] and valves of heart and the condition is known as BACTERIAL ENDOCARDITIS, but it is extremely rare to occur and cannot be concise to only chest pain as it has other symptoms also like heart murmurs, fever, chills,paleness, persistent cough etc. Chest pain can occur due to a number of other conditions which can be related to digestive problems like acid reflux and gas, cardiovascular[related to heart] or respiratory tract disorders, and you need to consult a Physician and get evaluated to get ruled out for the exact cause of pain. As far as infected and broken teeth are concerned you should make an appointment with a dentist and get evaluated along with x-rays so that the exact status of the teeth is ruled out and treated by either filling of teeth but if infection is deep Root Canal Treatment can be done followed by capping of teeth. Extraction may be needed in case where teeth cannot be saved and all the treatments will be followed by antibiotics and painkillers. Hope this information helps. If you find the answer helpful please give me a Five-Star Review and click on found the answer helpful as a token of appreciation. Thanks and regards. . . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, when i straighten my back, i feel a cracking sound, (similar to cracking your knuckles) its not everytime i straighten, maybe once every half hour or so, its beginning to hurt. somedays it will hurt alot and some days it will be fine. Its next to the right shoulder blade area of the back ### REPLY: Hi, thank you for posting. I have gone through your query and I understand your concerns. I think that you suffer from vertebral column arthritis. To confirm the diagnosis you need:1. Vertebral column X-ray.2. Fibrinogen test.3. Complete blood count.4. Urine test. The treatment of this disease contains non-steroidal anti-inflammatory medications. Massage is also recommended. Consult your neurologist. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been on the pill for almost 2 years and a week after having sex this month i got a tiny bit of bleeding for 2 days. at the begining of my pack of pills for this month i missed a few. im now confused whether the bleeding means im pregnant or is just because i missed some pills? ### REPLY: Hello dear, I understand your concern. In my opinion when the intake of pills is irregular like missing etc. the protection with the pills decreases and there will be risk of pregnancy. The bleeding can be due to either hormonal imbalance caused due to irregular intake. But pregnancy should also be ruled out as there are chances for pregnancy too. Consider getting a urine pregnancy test done after a week of missed period. If the period is delayed for more than 10 days to 2 weeks consult your doctor for further management. Best regards... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My height is not increasing???? I am 20 yrs old and sometimes I get pain in my joints and in hand muscles after sex and when I dont do sex my penis starts paining what to do to increase my height sugest some medicines to increase the heigt without any side effects ### REPLY: Hi, thank you for providing the brief history of you. A thorough clinical examination of the joints is advised with laboratory assistance for hormonal level. An endocrinologist may help understand the hormonal status and may advise some GH stimulating medicines as per the needs. Also, doing regular pull-ups will help improve the height and also some cardio training will help reduce the joint pains. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my sixteen yr old son went to the dr this wk for back pain,x-ray showed he was completely full of bowels...he told him to take two dulcolax then drink eight doses of miralax put into 64ozs of gatorade he did this and since has been going..but no substance just liquid..i m concerned he s not actually getting out the hard substances? ### REPLY: Hi... Thank you for consulting in . I think your kid is having habitual constipation. I have certain questions and suggestions for you. Questions:1. Did your kid pass motion or meconium on day one of life?2. Since how long is the kid constipated?3. Does the kid have any bleeding along with hard stools?4. How much milk does the kid consume per day?5. Does the kid eat fruits and vegetables (fiber diet) appropriately? Suggestions:1. Natural methods are the best to relieve constipation.2. Constipation is a risk factor for UTI3. Maximum milk consumption per day should not exceed 300-400ml4. Minimum 3-4 cups of fruits and vegetables to be consumed per day5. Toilet training - that is - sitting in Indian type of lavatory daily at the same time will help a lot. You can answer the questions at the following link - www.ChatDoctor .com/doctors/ .  I am happy to help any time. Further clarifications and consultations on  are welcome. If you do not have any clarifications, you can close the discussion and rate the answer. Wish your kid good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have chronic back pain, S/P slip and fall x 2 occurances. (Pinched nerve, DDD, and second fall: hernation with tear of disk). Multiple facet injections, 13 epidural injections and 2 years ago last procedure of radio frequency. (All have worked for a time frame of 8 months to 1.5 years). Currently have chronic lumbar pain into bilateral gluteus muscles and right side radiates into thigh down to toes (on the worst case senerio, usually stops in mid thigh). Last 5-6 months numbness noted in left lower abdomen started as half dollar area now grapefruit size area. (Feels like lidocaine feeling after teeth filling). Last back procedure was Jan 2013 radio frequency. What could this be? Edema? Work as floor RN. Thanks! ### REPLY: Welcome to  I have gone through your query and understand your concern. You can discuss with your doctor about it. You are having degenerative disc disease. Your abdominal numbness can be related to radio frequency ablation or compression by pressure by degenerative disc. You need to do MRI lumbar spine to see compression. Analgesic such as ibuprofen is helpful in neuralgic pains. Mecobalamine is helpful in recovery of damaged nerves. Hope your query get answered. If you have any clarification then don't hesitate to write to us. I will be happy to help you. Wishing you a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Taking Bystolic 2.5mg. OD; Having two knees replaced next month ; been taking Instaflex for almost 2 years. it has helped  a lot, but I am Bone on Bone in both knees now. Hard to walk.I have to stop Instaflex, + Anacin, 3 xs a day ( 2 weeks before surrgery) . Is there a reaction to stopping it completely? Dr. said no Blood thiners !Dr. perscribed Tylenol with Codeine to use, if Reg. Tylenol doesnt work. ### REPLY: HIF your knee surgeon has suggested stopping meds 2 weeks before, trust it won't harm.but there should be physiotherapy of both knees for good result post operative. Instaflex is a nutritional supplement claimed to prevent cartilage deterioration.its stopping won't revert changes in 2 weeks. Blood thinners are taken to prevent clots.if you are already on it for some heart issues or other clotting issues, you may recons ult your treating doctor...they are usually stopped before any surgery 2 weeks before to prevent excess bleeding during operation ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have been diagnosed as having impaired glucose tolerance. In the last one week I have been experiencing a tightness in my upper chest and throat.  I have had an Xray done and everything appears normal. My face appears bloated.  I am a 57 year-old woman ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you something and give you my opinion. You should know that typical heart pains have some characteristics. Usaly they are retro-sternal, upper chest pains likes quizzing, tightness or heaviness. They high irradiate to both arms, neck and jaw. They last from 5-20 minutes and usually start during a physical activity. The fact that you have an impaired glucose tolerant makes you at higher RISC for cardiovascular disease. So, as you are experiencing chest pains my opinion is that you should do some examinations. I would recommend an electrocardiogram, a cardiac echo, cardiac enzymes and a street test. After this you might be sure that's nothing to worry about or something else that should be resolved. Hope I was helpful. Best regards, .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, myself dr, a. mishra (veterinarian), my 3 yrs old daughter was suffering by cold,nasal discharge,cough, some times vomiting with mucosal discharge. primarily she was treated by the doc. with azithromycine, lansoprazole with cough syrup. now dr. wants to give inhelar. should i give it or not? ### REPLY: Hello dear!I want to ask about the family history. Is there any family history of asthma and allergy?? Does your child suffer from cold very often or quite frequently he is hospitalized or visits a doctor due to respiratory problems? If no then there is no indication of inhaler at this age. I would advise a good anti histamine like cetirizine or levo-cetrizine about 3.5 ml at night and montelukast sachet 4 mg at night for about 3 months. Avoid cold . You can also try some home remedies like a teaspoon of honey in a glass of Luke warm water to  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 42 year old female, overweight often have back pain.  I fell forward over two stacked milk crates, did not hear a pop or have immediate pain, however, 20 minutes later i was unable to walk without pain in the  lower left part of my back.  It seems like the pain comes when i twist my back in any way. There is no specific spot that hurts if I touch it and it does not feel warm.  I am used to back pain from stress and strain, but this feels different.  Should I ice it as if it is a pulled muscle, or heat it? ### REPLY: Hello dear, The symptoms as mentioned in your post can be attributed to muscle spasm secondary to the fall. Symptomatic relief can be obtained by taking analgesics like Diclofenac with serratiopeptidase (to be taken after food), application of analgesic+muscle relaxant ointment, ice compression & adequate rest. Physiotherapy therapy exercise will also be helpful. If symptoms still persist, kindly get an X-ray of lower back done to rule out any pathological cause for your symptoms. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, my friend has 4mm sized kidney stone stone and hes bearing microscopic hematuria since 6 months but he is not bearing any clinical features. One urine test for RBC morphological test has shown that he has dysmorphic and fragmented RBS, is that the condition that he is the victim of glomerulus diseses????????????wating for the positive response as soon as possible. ### REPLY: Dysmorphic RBC indicate that the source of blood is the glomerulus-the filtering unit of the kidney. It might occur in common conditions like high blood pressure, diabetes or intake of .  Other possibility is glomerulonephritis. If there is no significant proteinuria (excess protein in urine) then the kidney affection is not very significant. However, he needs full investigation by a urologist first like ultrasound of urinary tract, blood test for kidney function and possibly cystoscopy. His 4 mm stone in the kidney does not need any treatment. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I normally have a heavy flow when i start my period it usually last a week or a week and two days give or take but when i went to urinate i whipped and saw that there was barley any blood at all not even enough to call bleeding there was also a clearish gooey substance there as well im wondering what could be wrong because my flow is normally really heavy and last for a week or so....what could be wrong ### REPLY: Hi, Thanks for the query. Scanty flow during periods is called hypomenorrhea. This can occur due to many causes like :- Hormonal imbalance as in poly cystic ovary disease, stress and strain, weight changes etc-Thyroid abnormalities. - Anemia etc.- If there is any possibility of pregnancy, better to rule out ectopic pregnancy or miscarriage once. If there is no possibility of pregnancy, you can watch in the next cycle. Possibly by improving the nutrition the flow may improve in the next cycles. If there is possibility of pregnancy, once consult gynecologist, get examined and go for ultrasound. By this workup the possible cause for your problem can be identified and treated. 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 granddaughter is in the ER with severe stomach pains. She has had these pains for quite a few weeks. Now she is vomitting green bile, has not had anything to eat in 24 hours as she can t keep anything down. She is also dehydrated. Doctors said to follow up with a gastroenterologist. She cannot stop vomitting etc and they want to send her home. this doesn t make any sense to me. She graduates in 5 days and can t even stand up. What could be the problem as the ER doctors don t seem to be doing anything to help her. ### REPLY: If such patient comes to my clinic with severe abdominal pain and persistent vomits I will ask if she has passed stools or flatus? Then I would arise a list of testsUltrasound abdmnXray erect abdmnSerum amylaseFull blood countries possibility of intestinal obstruction is likely. I would keep her nil by mouth.v fluid I.v antibioticsPain killers Hope she would improve with conservative management, if not surgery is next option. It is better to consult general surgeon in your locality ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 was hit by a car about three week ago, he fractured his pelvis in three places but no other injurys. A couple days ago he started complaining about being dizzy, lightheaded, and passing out standing up. I called the hospital and they said there is nothing relating to the accident that would cause this. ### REPLY: HelloThanks for query. Treatment of fracture of the pelvis depends upon the displacements of bones. If there is stable fracture and no displacements of bones detected on X-ray no treatment is required except rest for 6 weeks. The symptoms of dizzies, light-headed on standing is most likely to be due to postural hypotension that develops after one suddenly stands from lying down position, and it is due to pull of major chunk of blood in legs resulting into momentary reduced blood flow to brain. You may get him checked by a qualified Physician to rule out any other cause for these symptoms. Getting up gradually from lying down position and sitting for a while before standing helps to resolve the issue. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello doctor I am suffering hairfall and dandruff 12 yr i had taken many tipe treatment like homiopathick and medicine but my hairfall and dandruf is nt stoping.resently i was taking tretment for one doctor bt no result.please advise me i am using shampoo daily (8x shampoo) can i use daily this ahampoo . ### REPLY: Hi, You seem to have seborrhea dermatitis on scalp...also called Dan .  There may be whitish flakes on the scalp. Itching may be there. Hair fall may be increased. Anxiety, stress and tension might exacerbate the disease. Pityrosporon oval may be responsible for the disease. You consult dermatologist for firm diagnosis and treatment. Mild steroid lotion with salicylic acid may be applied at night. And cleanse the scalp with ketoconazole containing shampoo. You dilute the shampoo in water and then rinse the scalp. You may do daily at bath. Orally, you may take antifungal like ketoconazole daily in morning for few weeks. Steroid may be taken in tampering dose. If there is itching, take antihistamines. Control of Dan ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 boyfriend is age of 20..when he is age of 15 he has stomach tb..after a one year he has pain in his stomach..but no docture can dignose this problem recently he known that he has amibiousis..and docture cure this desease bt again he having stomach pain and doctors says he has lax cardia..so what does it mean and how it dignose ### REPLY: He might have small intestinal TB rather than stomach TB. Amoebas also involves small intestine/some part of large intestine. If he has taken medicines for both diseases in form of a Complete Course, he should be fine. U can go for an oral+iv contrast CT scan of him. Now, the diagnosis of a lax cardiac can be confirmed by an upper GI endoscopy with manometry (if available). Lax cardiac may cause acidity with reflux. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 on tricyclen lo birth control pills. I missed two pills in the middle of my pack. I started spotting two days after and it has been on-going for the past week and a half. I am not due to get my period until Monday. But I have been bleeding/spotting for the past week and a bit. My periods normally only last 5 days. I m scared, what could be going on? ### REPLY: Hello, and I hope I can help you today. It is very common to have breakthrough bleeding, which is bleeding when you are not supposed to have your period, when you miss a birth control pill. The pill is out of your system within 24 hours which is like day 2 of your pill-free week, so some women will start to have a mini-period then.  You may bleed at the end of the pack, but if you don't, you should do a pregnancy test because missing two pills, even if you back them up, can trigger ovulation. So you don't need to worry about the bleeding, because that is just a side effect of missing pills.  This should not continue to happen when you remember to take the pill every day.  Keeping the pill with you at all times (like in your purse, instead of at home, so you have access to it wherever you go) can help avoid missing pills.  There are also internet programs and apps you can use as a reminder to take your pill. I hope this information was reassuring, and I was able to adequately answer your question, and that my advice was helpful. Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am pregnant and it is 9th week running.I am suffering from cold,cough,running nose,sneezing and throat pain. Can you please suggest homeopatChatDoctoredicine and dosage to treat it. Thanking you in advance -- Tanima(30 yrs) ### REPLY: Hi Sour av, In pregnancy medication should be avoided as far as possible, especially in the early pregnancy when the chance of causing harm to the baby inside your womb is very higChatDoctormon cold is caused by Virus, and does not require any treatment. It will go off by itself. Cough is not welcome in pregnancy as it causes increased intra-abdominal pressure, so you may take some cough syrup under direction of your obstetrician, to get some relief from cough.Don't forget to cover your mouth when coughing, otherwise it will spread to all the members of your household. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recovered from a chest cold, but the coughing remained. Its now 8 weeks. I have a clear nose, but bad postnasal drip (clear, but very stickey) at night. It actually keeps me awake as I feel the need to swollow all the time. When I cough, I get nausios - it feels as though I m coughing all the way from my toes up. When finished, I can t get air back into my lungs. The gulping for air causes me to burp afterwords. Now, i ve developed a tightness around my abdominal area with specificly being uncomfortabele behind my lower left ribs toward the middle. My upper mid-back also feels stuck . Could this be due to the bad coughing spells? When should I see my dr? What could it possibly be? ### REPLY: Hi and thank you for choosing  to post your question. I read carefully your question and my opinion is as follows:Your cough is considered subacute. The most common causes of subacute cough are: 1. Respiratory tract infection with Bordetella pertussis that is a 6-week disease divided into 3 stages, catarrhal, paroxysmal and convalescent stage. Catarrhal stage is characterized by nasal congestion, sneezing,tearing, low grade fever. The paroxysmal phase is characterized by paroxysms of intense coughing and possessive vomiting and turning red with coughing. Convalescent stage is characterized by chronic cough which may last for weeks. In this case antibiotics have little value. In this situation antitussives (such as codeine), bronchodilatators (such as Albuterol inhaler)can help relieve the symptoms.2. Postnasal .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 plz can you help me??My daughter is 7 months and noted that it has a change in the form of nails right foot (finger 2, 3 and 4) with a blue spot in the skin on the neck with that of her birth was a process and weight at birth was 2 kilo and 700 grams, but they do not suffer any health problem. What should I do? Nails become circular, curved ### REPLY: Thanks for consulting in Healthcare. We should differentiate next diseases:1. Iron deficiency anemia caused lack of iron in the food.2. Lupus erythematous, which we exclude after blood test3. Lungs problems;bronchoectasis4. Polycythemia, a condition where the blood is too thick5. Fungal infection A blue spot on the neck is more often Mongolian blue spot, congenital, a benign, flat, congenital birthmark with wavy borders and irregular shape. Do you know it is also extremely prevalent among other East, Asian peoples? Mongolian blue spot usually disappear till the end of first year.  What should you do. If I were your doctor I would check your daughter blood test: hemoglobinum, RBC etc, iron, liver test, check lungs function, consult at dermatologist. Best regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I have a history of kidney stones and I recently just passed another stone back in December. I woke up today, though, in terrible pain. I feel like Im going to vomit, like something tight is gagging me around my neck. Im very hot. There is blood in my stool and I dont think Im going to leave the bathroom any time soon. Could this be another kidney stone? Or is the blood in my stool from something else? Your response is very important to me. Please and thank you! ### REPLY: Hi, Renal calculus when passes through ureteric wall it irritates it n have severe pain in flank which can radiate to groin thigh umbilicus scrotum /labia major associated with nausea vomiting and other urinary symptoms including hematuria. It never causes blood in stool which can be due to pathology in GIT.  So visit a gastrosurgeon for bleeding PR and Urologist for your Renal calculus. Hope this ll help Thanks n 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: Son has swollen knuckles middle joint, seems to. Ache a lot. Nothing terribly serious but after an activity, he wears out quicker than most and complains of minor joint pain in his ankles a arms. Tonight he said he has some shaking in his hands. He has Aspergers so I know he gets anxious but don t want to miss something. Also he has stretch marks from rapid growth spurts. Any direction I should look into? Thank you ### REPLY: Dear Patient, Welcome, and thanks for sharing your concern I went through your query, and I feel, the most important thing that you need to rule out, is inflammatory arthritis, and for that you need to get his investigations done, get his CBC, ESR, CRP, CCP RF done and see if anyone is abnormal and indicative of pathology, if not than stay cautious and repeat these after a period of 1 year. I hope my advice would have been useful, in decision-making regarding your treatment, still if you have any clarifications or doubts feel free to contact back. 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 started drinking the body by vi shakes about a month ago.  In the last few weeks my asthma has become out of control, it was quite mild to begin with.  The shakes were the only change I have made to my lifestyle.  Could I be allergic to them? Please help! Thanks!! ### REPLY: Hi, vi shakes contain concentrate of proteins and these can be immunogen to you, or you can say that you are allergic to its constituent, so you should immediately stop its use anymore. To confirm it you may go for its patch test on your back. As your asthma tells about your atomic nature, and you might be allergic to several substances occurring in nature, so it is better to avoid it and all those which are allergic to you because then only your asthma can be managed.yew can go for complete panel allergen test to get a list of all allergic food to avoid any such episode in the future. Thanks and take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother-in-law cleans the bathroom with a mixture of pine-sol and clorox. I have been breathing it in for a few days and have been coughing up phlegm, have trouble breathing and am wheezing. Im leaving in 2 days and have asked her to stop using it around me. Do I need to see a doctor? ### REPLY: Hello dear, Wheezing is caused due to bronchoconstriction (obstruction of smaller airway passages) which is indicative of Hyper-responsiveness of air passages. Management consists of:1. Stalin+ Aeroflot inhaler-provide symptomatic relief by causing bronchodilator (dilating the smaller airway passages, relieving the obstruction & increasing airflow to lungs).2. Montelukast preparations- used as a maintenance therapy to relieve symptoms of asthma.3. Antihistamines like Cetirizine and anti-tussive preparations can also be used to provide symptomatic relief from cough.4. Also make sure that you are well protected from exposure to cold, dust or other allergens. If symptoms still persist, kindly consult a Pulmonologist for proper clinical evaluation. Wishing a good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, am 31 year old male. Hace been feeling some sort of pain while sneezing and coughing for the last couple of days. I recently started execercising(just 4 days before after a long break) and feeling the pain since then. Could you please help me. It hurting even when I try to sit on a chair.Thanks ### REPLY: Thanks for your question you need to consult a Pulmonologist who can request for some blood investigations and a chest X-ray to rule out some causes like infections it can be due to bacterial or a viral cause better to get evaluated nothing to panic if there is some infective because it can easily b e dealt with by taking some antibiotics which will be prescribed by your physicianthanksfeel free to ask more questions ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 blood pressure is 150/105 i workout between 4 to 6 days a week for 30 to 90 min wieght train with dumbbells 3 to 5 time a week different body parts  eat smaller portions and 5 times a day small meals, i am 5 0 and 181lbs 42 yrs old female. what can i do to lower my blood pressure? ### REPLY: Hello, Are you under any medications?  Are you a diabetic patient? For how long your blood pressure is quite high? Are there any other symptoms other than high blood pressure? I suggest you take a tablet Telmisartan once daily for three days. If your blood pressure is still high, I suggest you take an ECG and consult a physician. 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 had 2 back opps last 1 was in feb 2011 i had mri they say i have nerve damage and my legs are always tight and when i walk my hips get sore and my back i go for deep tissue massage for the last 8mths but it does not seem 2 help and i do back stretching exercise iam on 150mg of amitriptyline as i also have R L S and the nerves twitch all the time so what else could i do 2 try and help myself ### REPLY: You can try spinal pain pump. An Intrathecal Pump is a specialized device, which delivers concentrated amounts of medication(s) into spinal fluid area via a small catheter (tubing). This device delivers concentrated amounts of medication into spinal fluid area allowing the patient to decrease or eliminate the need for oral medications, better pain relief and spasticity control with fewer side effects. It delivers medication around the clock, thus eliminating or minimizing breakthrough pain and/or other symptoms. 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: for the past 4 weeks i have been getting little pains in the left side of my chest. i have also had pain in my left shoulder, which as also gone all the way down my arm sometimes it is like a burning sensation. i have seen 3 doctors and they say it is anxiety, i have been for an ecg and that came back absolutly fine but i am a constant worrier i am 22 plz help ### REPLY: Hi, Regarding your concern, I would like to know if the pain is triggered by shoulder movements or body movements. This would indicate a shoulder joint local inflammation or any other musculoskeletal pain.  Otherwise, I would recommend performing some further tests: - a chest X-ray study- a shoulder X-ray study- a resting ECG-complete blood count, PCR, ESR for inflammation.  An exercise cardiac stress test may be needed.  Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have recently had a chest xray following being rather breathless over the last few months. I have now been asked to go for a ct scan as the xray showed a shadow that the gp wants to look at further. I am going out of mind with worry - assuming the worst! Does this necessarily indicate anything serious, or could there be a harmless reason for this shadow? Many thanks. ### REPLY: Thanks for your question on . I can understand your concern. Honestly speaking, possibility of some serious lung disease is more in your case. Your symptoms (breathlessness) has worsened. So shadow on chest x-ray can be due to pneumonia or lung cancer. So CT scan is needed to confirm the diagnosis. If you are smoker, possibility of lung cancer is more likely. Better to consult pulmonologist for this. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My mother had suffered from dysentery from 7-8 days...after some tests and sonography it was found that she had sacralisation of the fifth lumbar vertebrate and now she is taking medicines...but she is feeling very low and is having unconsciousness in a way that she can t even get up from the bed..what it means?? ### REPLY: Hi, thank you for providing the brief history of your mother. As you mentioned your mother has sacralization and is under medication. Since medicine can provide the .  Also, you can ask her to do some breathing exercises and use hot water fermentation for lower back if she is having low backache .also, as you mentioned she has dysentery, she must have lost a lot of energy from the body. So for that you can provide her diet to cool the stomach and more fluids to keep the body cool. Once she recovers slowly, and gradually you can put her on simple exercise under the physical therapist as it will help improve her metabolism and immune system too. With the grace of God I wish your mother a good health. If you have any queries you can ask me further. RegardsJay In ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi. I went to the Dr this morning because  for the past 2 weeks, I have had extreme fatigue, low grade fever, and bad headaches . I was diagnosed with pneumonia. This evening, I noticed that the top of my spine is enlarged  and painful to the touch. Do you  think it could be related to the pneumonia? ### REPLY: Hi, thank you for posting. I think that your problems are related to pneumonia. The symptom you are experiencing is a muscular pain. Beside the symptoms such as: cough, fatigue, fever and short of breath, Pneumonia is manifested with muscular pain. Muscular pain is caused due to bacterial toxin production. Except the treatment with antibiotic and anti-cough medicines, you should take painkillers.However, you should consult your neurologist. All the best. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Have for over six months suffered from lower abdominal pain, like period pain, although am 63. I also suffer from lower back pain due to disc problems. Mainly left hand side. Sometimes severe. Had blood test for ovarian cancer which was negative. Feel bloated and suffer from constipation. ### REPLY: Hi. Thanks for your query. Let us simplify:The pain in lower abdomen like a period can be due to a systole or reconcile associated with prolapse of uterus, and you need a physical examination by a Gynecologist for this. If too large, you may have to undergo corrective surgery. Bloating and constipation will simply be alright with the right dosage of laxative most suited to you and relieves the problem too. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 type one diabetic with sever seasonal allergies. I have tried all over the counter (claritan, zyrtec, etc) as well as homeopatChatDoctoredications and nothing works. I have seen many allergists that tell me that taking steroids for the allergies would be worse due to elevated blood sugars but they are the only thing that works (i tried them many years ago after begging and pleading) I feel as though my sugars are more out of control due to the persistent chest, nose, eye, etc problems caused by the allergies. Do you think it would be impossible to find a doctor to prescribe a type one with an a1c of 7 some steroids for seasonal allergies? Also do you really think it is more dangerous to take steroids and have my allergy symptoms go away rather than live with highs due to the symptoms? thanks! ### REPLY: Hello, Thank you for asking at . I went through your history and would like to make suggestions for you as follows:1. I would like to know about your symptoms in detail like since how long, how often, what are your nose, eye, chest symptoms, which medications you used, which forms of steroids you used, dose of insulin for type I diabetes, any other medical conditions, any other medicines, your previous reports, etc. etc. This will help me to understand your complaints better and to make more specific suggestions for you. As you have chest symptoms, I would definitely like to know whether you have asthma, since when, inhaler use, etc.2. As long as nose/eye symptoms are concerned, I usually prescribe my patients' combination of levocetirizine + montelukast regularly.3. Regular steam inhalation also helps in a long run.4. I would like to mention here that there are many forms of steroids available, tablet, intranasal sprays, inhalers, etc. Most side effects, including weight gain, increased blood sugar, etc. occur with tablet/oral form. Sprays and inhalers are very safe as compared to oral forms, and choosing appropriate form may help to ensure minimum side effects with maximum health benefit. 5. Of course, . 6. For diagnosis of allergies, I would suggest you allergy testing for common air-borne allergens such as house dust mites, pollen, molds, insect proteins, animal dander, etc. This will help you to identify the substances causing allergies to you as well as to know the measures to avoid them.7. Based on allergy testing, an Allergist-Immunologist may prescribe you allergen specific immunotherapy which works on immune system to gradually improve allergy symptoms.8. In general, please avoid exposure to dusts, smokes and air pollution as much as possible.9. Regular physical exercise including breathing exercise and a diet rich in vitamins & minerals also will help you in a long run by improving your lung capacity and immunity respectively. Hope above suggestions will be helpful to you. Should you have any further query, please feel free to ask at . Wish you the best of the health ahead. Thank you & 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 cried alot last night because of something, and since then i have difficulty in breathing,  unable to lie down comfortably,n if i try to take deep breath i feel a wierd n mild stuffy pain in my chest.there is also a weezing sound when i breathe.plz help. ### REPLY: Hello, Certain emotions like excessive crying, laughing, fear etcetera can cause bronchospasm. This, in turn, causes wheezing, cough, breathing difficulty etcetera. So better to consult a pulmonologist, and get done a clinical examination of the respiratory system and pulmonary function test (PFT). If PFT is showing an obstructive defect, then you will mostly improve with inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). Avoid excessive emotions like crying. Hope I have answered your query. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a small bubble on my top gum. I doesnt hurt all the time just sometimes. When I push on it pus come out and it smells and taste really bad. I have been telling my dentist for a year that Ive had a cavity but he says he cant see one. Any idea what this could be? ### REPLY: Thanks for your query, I have gone through your query. The bump on the gum could be because of the tooth infection secondary to the decay, or it can be secondary to gum infection. Consult an oral physician and get it evaluated and take a radiograph to rule out tooth or gum infection. If it is gum or tooth infection You can take a course of antibiotics and analgesics like amoxicillin 500 mg and metronidazole 400 mg TID for 5 days(if you are not allergic).  After taking antibiotics you can get the tooth treated with RCT(if bone support is fine) for tooth infection. If it is gum infection then get your teeth cleaned once and maintain the oral hygiene. If needed grafts can be placed to make the tooth firm. Do saline gargling. 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 gum is swollen just under my moler.  The top has one white patch, but it isnt red all around like some of the photos I have seen.  I had it before my last cleaning and my dentist said it was likely just trauma from chips or something, after taking an ex-ray.  He said it should clear up in a week or two, but now it has been a month.  It is slightly tender, but not to bothersome. ### REPLY: Hi. Thanks for the query. As per your complaint pain and swelling of the gum under a molar can be due to either deep infection in the gum due to deep impaction of any food debris in the gums or can also be due to decay in the tooth causing infection below the root tips. If the gum swelling is not reducing you should consult a Periodontist and get evaluated. As of now you can apply antiseptic ointment like Chlorohexidine over it along with numbing gel containing Lidocaine. Do warm saline gargles. Further treatment can be planned after examination by the Periodontist. 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: Im Shambala age - 31, trying to conceive from last 6 years, Height is 5 inch weight is 54kg my FSH level is 12.30 and AMH level is 1.3, do I have some time in hand or need to go for IVF now? and what is success rate of IVF according to FSH and AMH level ### REPLY: Hi, I think you have a high FSH and low AMH level. These values indicate that you have less number of follicles in your ovaries.  So, you should not waste your follicles by timed intercourse and GUI. It's not that you can't conceive by them, but there is less chance of pregnancy with these. IVF has a better pregnancy rates of 40 to 50 percent while timed intercourse and GUI it is around 10 to 15 percent. So, IVF is a better option for you.  But if you want some time, you can try GUI for 3 months. Hope I have answered your question. Regards .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi.  I accidentally fell down the stairs about 6 weeks ago and severely bruised the back of my thigh (think about the size of your hand).  It has faded considerably and a light yellow area can be seen where the bruise used to be.  Ive still got some sensitivity in that area.  How much longer should I be having this pain? ### REPLY: Hello, What I can infer from your injury is that it was a soft tissue injury which is healing slowly. I think six weeks is an ideal time for it to heal. The sensitivity what you are experiencing is present during the healing phase the skin changes can sometimes take up to three months to completely go. I think a wait for two weeks more and then consult your physician again. Hope I have answered your query. Let me know if I can assist you further.   ### END