Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Sir good morning, My father age 50 year is suffering from hepatitis B from last 1 years. a Gastroenterologist Dr. Advise medicine Hepdoz 300 OD & he say that the liver is damaged ( Sirosis) i fallow the treatment & investigations 1 years but we are not satisfied with result, now i m given liv 52 hb (BD) & syp hepavin (BD) from 1 month PLZ advise me dose & duration of this medicine for HBSAG negative Tech. Rajesh Tiwari Avadh Hospital, Gonda U.P, India ### REPLY: Hello! Thanks for putting your query in . I am a Gastroenterologist (DM). Presently with the available treatment for Hepatitis B like Hep doze which have been prescribed to your father is one of the best medicine. Present treatment cannot make Bag negative, only there is around 5% chance of complete disappearance of virus from body. He has developed cirrhosis which is irreversible. You may add tablet Adílio 300 mg twice a day. Hope he has not developed ascites or altered behavior (Hepatic encephalopathy) till now. So he has good prognosis overall. No other treatment is available at present. You have to understand that. I hope I have answered your query and this will help you. If you have any further query I will be happy to answer that too. Remain in touch and get-well soon. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, im 19 years .... i cannot retract my foreskin when penis is fully erect but i can do it in flaccid state. However,if id retract it every day for cleaning, that would cause fissures - the foreskin is sticking to the glans, so when it is retracted small pieces of the glans are tearing ... and it even got blood one time.  Please tell me, should i do something different when i retract it ? Is it normal for foreskin to be sticked to the glans ? i am really afraid to retract it, i do it only 1 time per week maximum ### REPLY: Hi and. I think you are suffering from fibrosis, Mitosis is the inability to retract the foreskin behind the glans in males. Physiologic fibrosis is the normal condition in which child . The inability of the foreskin to retract can lead to difficulty cleaning of the area which can cause Atlantis, there can be difficulty or painful urination, painful erection, or paraphimosis. Your doctor can diagnose fibrosis based on a thorough history and physical examination. Additional tests are usually not necessary. The first choice of treatment is usually a steroid ointment that is locally applied. This treatment has shown a success rate of over 70%. The ointment softens the foreskin and is applied for 4 to 6 weeks. Once full retraction is possible the ointment is discontinued. If the steroid treatment is not successful, a circumcision might be beneficial. When penis is fully erect the fore skin should retract without any problem, but in your case you have mentioned that you cannot retract it completely which is not normal. Please consult a surgeon, and he will examine you and may suggest a small surgical correction called Circumcision. After the surgery you will be discharged on the same day. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir, My son is 1.5 yrs old and he is suffering from cough and cold. Last year also in winters he got the problem of bronchitis and this year from starting only he is suffering from cold. can u suggest me something which i can use the whole winter to avoid cough and cold and also the problem of bronchitis? ### REPLY: Hi, Thank you for asking question on . Stem inhalation at once daily if possible. Local instillation of saline nasal . Zn-20 syrup 5 ml daily may prevent repeated colds and cough. You may try Flu cold syrup 3 times daily for relief of cold. Karvol applicant to be squeezed on a hand kerchief and pin it to his garments so that he will be inhaling the smell continuously. Hope this answer will serve your purpose. Keep the child warm and avoid exposure to cold atmosphere, cold foods and cold  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 first noted my wife was having memory issues at the age of 56 and Alzheimer s. He did give her a CAT scan and said it was normal, and then put her on some medication that is all he did he has had diabetes added been on insulin ]quite a while and was taking to her neurologist now she is starting to have tremors and she is right-handed and now is unable to hold things in her right hand, but she can enter last. I have had to put her in a nursing home, but I do not think this is doing her any good at all. We have tried to get her in local neurologists in the area. We have changed doctors that since this first neurologist had seen her. He has now left the country, and none of the neurologist around here. We will see in a of his patient. What can I do, I am lost. We really did not get a true diagnosis because hardly any test, and the CAT scan and the CT scan, other than blood ### REPLY: I read your question carefully, and I am sorry about the situation you are in. It is difficult to make recommendations on treatment though because I am not sure if she has Alzheimer's. Dementia can have many causes, Alzheimer's is the most common, but there are other possibilities to be excluded such as vascular dementia (repeated strokes), vitamin B12 deficiency, low thyroid function, Parkinson's disease just to name some common ones. The fact she manifested symptoms at only 56 is a red flag to consider a diagnosis other than Alzheimer's as it typically occurs later. The tremor you describe is also not typical for Parkinson, makes stroke, Parkinsonism syn . So the way to go is to check what blood tests has she exactly done, have thyroid function and vitamin B12 level been included. Also while a CT might serve to exclude some issues, generally an MRI is a recommended exam as it gives more info on the atrophied sites or old lesions which could orient the diagnosis. A neurological exam also is needed, although I understand the difficulties you are encountering in finding a neurologist, she should be evaluated for Parkinsonism or other neurological signs as well as have some neuropsychological tests to determine what areas of cognition have been more affected. I hope things work out for 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 ve had tonsillitis for a month now it started in my left tonsil where there was pus and my doctor gave me erythromycin. It cleared up and a half week later my right tonsil became swollen but no pus. I ve had CBC tests done WBC counts done and swabs done everything has come back negative. The pain was bad I ve been in and out of the hospital and doctors. I was put on azithromycin 3 days ago and had some side effects and was taken off my doctor called me today to discuss the results and said i shouldn t be on antibiotics because my WBC was about normal. He thought i could have oral gonoreah so we did swabs and I m still awaiting results. I saw a net at the hospital who did a ultra sound in my tonsil to check for a abscess and she said she couldn t see any puss inside, which made me feel better at the time. They then also discussed a possibility of a oral std and gave me a antibiotic via injection and benadryal at the same time in case i was allergic to the new antibiotic. They also gave me oral steroids and the next day the pain was do able. As the day went on the pain began to come back. I am so confused is this a viral infection? My blood tests which ive now done many and swabs have come back negative for any infections or bacteria. The doctor at the hospital said my monocytes were high on the CBC then she did a further test and said they were not actually high. The pain is still here its very frustrating i down know what to do my doctor has stopped my antibiotics the azithromycin until further notice on the oral gonoreah test he said if it were to be positive he d put me back on it. I m pretty scared at this point i feel like i will never get better i feel doomed and i don t know what to do now ### REPLY: In my opinion for your query the expert you're visiting is not wrong, and it is very important for you to stay calm. Ask you expert to kindly serve you with symptomatic management(pain relief). Wait for the result of the test. I would recommend you to perform Luke warm salt water gargle thrice a day. There is a procedure of tonsillectomy which could be performed but for that your expert is trying to rule out all causes of infection. Have patience and don't give up. I am sure you will be well soon. Take Care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had upper right abdomen pressure radiating all the way down to my right groin area for awhile now but today I started having sharper pains in my left side mid to lower abdomen. I haven t had a regular bowel movement in months. Could this all be connected? ### REPLY: Thank you very much for contacting . First you have to do your abdominal ultrasound sonography for diagnosis. Intestinal infection, diverticulitis or chops disease may cause this type of symptoms. You don't mention exact site of pain and aggravating factor and time duration. That helpful for diagnosis. Proper physical examination and history give exact idea. Consent a physician for further diagnosis. I hope my guidance is helpful to you. Take care. Thank you very much. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 suffer with nauseaus and gas pretty well constantly  My internals feel so swollen and sore.  I feel tense and stressed with it.  My sleep pattern is very poor as I feel  much worst when I am laying down.  I have lesions on my liver, cysts on my gallbladder  and polyps in my kidney.    Some times when my condition really gets disccomforting I feel a  nauseaus and a hungery nawing feeling in my stomach and then  very gassy feeling it settles in my back just under my shoulder blades.  This is very uncomfortable and I cant lie down I just keep walking around I feel so nauseaus and feel like I am full of gas that is lodged in my back and is unable to free it self.  This issue always lasts 6 hours.  I have to be very careful  of what I eat the next morning as sometimes it will start up again.  IIhave had this  conditionfor a long time and it is interferring  with me having a good quality of life.. ..  I have had blood test and a few other tests but nothing has been determined. I am having a a gastroscopy in December of this year.  I am wondering if I may have symtons of stomach cancer or some other type.    I know this is hard to determin but have you any suggestions on what  I could be doing? ### REPLY: Hello, Thanks for the query to . Forum. Cyst on the gallbladder, it is not very clear at which part, this cyst is having, please mention. As far as concerned about nausea, gassy stomach, vomiting. May be due to hyper acidity, gastritis, tension, indigestion, Fatty food (not digest due to cyst in gallbladder). May be due to ulcer in stomach. These symptoms didn't indicates towards cancer of stomach. Consult a physician/ surgeon (stomach problem & gallbladder) and get their opinion and help. Hope I have answered your question. If further any question I will help. 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: Hai i am a female with age of 34 getting hair loss from 1to 2 years having thyroid problems,and i am also suffering from dandruff problem with itchy scalp.what is the the solution to my hair loss,working witChatDoctorputers whole day  YYYY@YYYY  this is my email address. ### REPLY: Hello, Welcome to . Hair fall for 1-2 years is called as chronic halogen effluvium. The common causes include anemia and thyroid abnormalities. Please get your hemoglobin, serum ferritin levels and thyroid status evaluated. You need to continue treatment for your thyroid issue. If the above tests are normal, you can take a tablet with biotin, cysteine and methionine for 3 months. This will strengthen your hair roots. For 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: I had mandible surgery a year ago and had to get 2 titanium plates put in. Recently Ive had pain in my teeth and jaw around the break. So bad that painkillers Dont stop it and even wakes me up in the middle of the night. Whats the cause, and what should/could I do? ### REPLY: Thanks for your query, I have gone through your query. The pain in the site of plate or fractured site can be because of the infection near the plates or any infection from the teeth near to the fractured bone site. Following trauma usually the teeth will lose its life. So they are prone to get infected. Consult an oral physician and get a radiograph done to rule out the above said causes. If it is a tooth infection, then get the tooth treated. If there is infection near the plates, get the plates removed. Meanwhile take a course of antibiotics like amoxicillin and metronidazole. 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: I have been diagnosed with Hemoglobin C disease and recent bloodwork indicated that I have a hemoglobin level of 9. I feel tired and I have a headache. I am eating more veggies and taking vitamins with iron. What kind of complications can result because of that? Thanks for your help. ### REPLY: Hi, dear. I have gone through your question. I can understand your concern.  Low hemoglobin level cause weaknesses, headache, dizziness, palpitations etc. If it further decreases then it can lead to congestive cardiac failure. So you should take treatment of that. Consult your doctor and take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Ive got a lumps under my jaw line under the skin that arent visible but can be felt with the hands. They do not hurt although they can catch (it feels as though the lumps have been caught by the jaw bone).  I dont feel Ill but they can be uncomfortable when they catch. What are these lumps? ### REPLY: Hi Dear, Welcome to . Understanding your concern. Thanks for your concern. The symptoms you mention in query are can occur due to two things. Firstly there are many lymph nodes in that area, so the lumps can be lymph node swelling, which usually occur due to infection. Secondly the lump can be due to blockage of submandibular gland duct, which occur due to stone or any foreign body such lump is called muscle. I would suggest you to consult ENT specialist (ear, nose,throat) for proper examination. Doctor may order X-ray or CT scan of that region to confirm the diagnosis. In case of lymph node swelling doctor will prescribe antibiotics at least for week along with anti-inflammatory . If it is muscle then doctor may remove it surgically or perform marsupilization. Sometimes the lump that is immovable, hard and slow growing could be a cancer, so it is important to visit doctor and get it checked. For now give warm compresses and take Advil (if not allergic to it) or Tylenol for comfortableness and swelling. Hope your concern has been resolved. 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, My daughter is 1year and 1 month old. She got fever 15 days back which at times crossed 102 deg. At that time 5 doses of meftal p over a period of 36 hours brought the fever down and it went away subsequently. Now 2 weeks later fever has returned and it was over 100. We gave her Meftal P and 4 doses over 24hrs got her fever down. Now the fever is around 99.7, is it safe to continue with a few more doses of Meftal P so that it goes away completely or not ?? I have heard overdose of Meftal P can hurt the liver. Kindly suggest. Thanks in advance. ### REPLY: Hi, Thank you for asking question on . Meftal dose is 10 mg/kg body weight every 6 houlyOfcourse Prolonged use will cause side effects as you said. But Metal alone will not cure fever You have to find out the cause for fever and treat it. Better consult pediatrician. Hope this answer will serve your purposeless feel free to ask any more queries if requiredTake care . V. Subrahmanyam MD;Disassociate professor of pediatrics ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 had the MMR almost 2 weeks ago. No side effects really, her leg isn t even red or lumpy at the site of the shot. However, now I noticed a somewhat swollen lymph node on one side in the groin (same side that she received the shot on). Please advise. Is this normal? She seems to have energy, a few nights of fussiness, teething so appetite has been off and on but drinking milk regularly. ### REPLY: His presume your daughters age would be around 1 yr. Small nodes in the groin are common and usually due to very mild injury(many times invisible) to feet or legs which cause some bacteria to enter into the body.  The body fights them off and in the process may have enlarged glands in the groin. Vaccination with MMR may rarely cause it theoretically, but I have never seen it in my practice. Whatever the cause, it looks innocuous based on your description. Please keep a watch on it and report to doctor if size increases or if it becomes red or painful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 cracking in chest and shoulders with minor pain. Been going on for 2 years. If i sit for a while I need to stretch again and cracking comes back. Sometimes its hard to breathe until I take an aleve. Also sounds wierd but xanax helps. I feel good when lying down but when I get up froma sleep it starts again. Any answers? Thanks ### REPLY: Thanks for your question on . I can understand your concern. Your discomfort is associated with specific movement and position. So possibility of musculoskeletal cause is more likely in your case. So avoid movements causing pain. Avoid bad postures in sleep. Avoid heavyweight lifting and strenuous exercise. Apply warm water pad on affected areas. You are also improved with Xanax. It is anxiolytic .  So you are also having stress and anxiety. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. Counselling plays very important role along with anxiolytic  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello,I have a septated cyst on my right kidney. Recently, lower back pain and tummy ache when I pee.Recent urlne sample shows +2 protein and blood. I exercise a lot and have v high protein diet. Kidney function is fine. I get migraines though.My Dad has PKD...I saw genetics specialist today who suggested MRI. Im only 32. Is septated cyst likely to be cancer? If not, what is it?L ### REPLY: Hi, Thanks for using . Not all septated cyst are malignant, as you have family history of PKD, it could be a PKD, your pain abdomen and blood in urine could also be due to PKD.MRI is a better investigation for soft tissue swellings, better to get it done. Consult your doctor for examination and management. Hope I answered your question. Feel free to ask me if you have any further queries. Wish you good health. Take care. Regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello sir,i would like to consult some points regarding chest pain and my age is 30.1)in the middle of the chest i have a minor pain but not daily.2) have dry cough n feel uncomfortable to take breath when im in polluted area..3)have blood pressure 140/95 maximum time when i measure so wanna know what may be the problems n how to recover it? ### REPLY: Thanks for your question on . I can understand your concern. Chest pain, cough and breathing difficulty are commonly seen with bronchitis and asthma. Your discomfort is more when you are in polluted area. This means possibility of bronchitis is more. So consult pulmonologist and get done 1. Clinical examination of respiratory system 2. PUT (pulmonary function test). PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease. And treatment of bronchitis is based on severity only. You may need inhaled bronchodilator and inhaled corticosteroids on the basis of these reports. And no need to worry about high blood pressure. You can stillness control it with salt restriction in diet and exercise. Don't worry, you will be alright. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi my 2 year old son fell asleep very quickly after a slight bash to his head and never normally falls asleep that quick, I picked him up and normally he would wake up and stay awake after that but he just fell back asleep then I tried to wake him again and he wasn t responding I tapped him, tickled and blew on his face and nothing, I got really scared he was still breathing normal pace and after about 10 miniutes he then woke up and has acted his normal self since (1hour) what happened to him and why would he not wake when he s normally a very light sleeper? ### REPLY: Hello! Welcome on  ! I understand your concern, but you should know that the brain of child .  The increased sleepiness could be caused by a head concussion or a temporary loss of the brain normal function due to the head trauma. The best thing to do in this situation is to help him avoid a possible repeated head trauma in the next days. For this reason, it is necessary to stay next to him. I would also advise avoid heavy games, which need a straining physical activity or impose the risk of falling in the next days. Hope you will find this answer helpful! Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i have 6-12 hard very small nodules on the bottom of my scotum just under the skin surface ,  the area is itchy as well. if i pick one hard with my finger nails a small flesh colored nodule detaches. i occasionally shave down there but the issue is only on one side of the sack on the bottom where it meets my cuttox.  scabies, cysts, jock itch, infected hair folicles ### REPLY: Hi ! Good afternoon. I am  answering your query. Even though it needs a clinical assessment to have a proper diagnosis, from your history it seems that these might be multiple sebaceous cysts or might be some kind of warts. I would advise you to get it assessed by a dermatologist or a general surgeon in your area for a proper diagnosis and appropriate management. I hope this information would help you in discussing with your family physician/treating doctor in further management of your problem. Please do not hesitate to ask in case of any further doubts. Thanks for choosing  to clear doubts on your health problems. I wish you an early recovery. . ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: How do you treat an area on the top of the head which is red, pus looking but no real drainage. Just a red area on the to of his head in the balding area of his scalp. This occurred after wearing an acrylic beanie in the rain for approximately 4-6 hours 2 days ago. ### REPLY: Hello, there are 2 possible reasons for that one is Cyrillic caps are made up of synthetic materials. Also, perspiration difficult through the cap. Apart from that, the cap make the scalp warm and sweat more also. Wearing it for longer time make scalp sweaty. So it can produce the worn area a sweat rash, just like you described.  Other thing is it can be, contact dermatitis to the synthetic material it is made up of.  What can you do is you can change your cap to a wool one which is a natural material, and it let perspiration well also. Therefore, it causes scalp less sweaty and warm. Also, if you are having contact dermatitis to Cyrillic it would also be reduced from wool.  Topical anti-steroidal +antibacterial cream would help in healing the rash. Keep the area well .  Lactocalamine lotion can reduce itching.  Don't use the cap when the climate is warm. It will aggravate the problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have intercourse 2 says after my period ended and since my boyfriend thought I am less likely to ovulate at this time he ejaculated inside me twice. I did take plan b the next day but I was very nauseated and I am having some white discharge. Could I be pregnant? ### REPLY: Hello misunderstand your concern White discharge and nausea after taking plan B is not suggestive of pregnancy. If you had taken plan B tablet with in 24 hours then it is 95 percent effective in preventing pregnancy. Again you had sexual intercourse in safe period of cycle (Ovum is not released 2 days after period)Nausea is side effect of pill as it contain high progesterone.(It relaxes smooth muscle of GI tract)White vaginal discharge may be due to 1. Preparing for the with .  Vaginal infection: Sexual transmitted disease like bacterial vaginosis, chlamydia and gonorrhea should be rule out. So it should be ruled out by vaginal swab test, urinalysis and STD screening test. It should be treated by Antibiotic and proper pelvic hygiene. So chance of pregnancy is less. I pill can cause delay in period due to hormonal imbalance. If period will delay by the 10-12 days from the normal expected period than you have to go for urine pregnancy test to confirm the pregnancy. Use V vaginal plus wash, wash vagina with warm salted water to prevent the infection. Hope this may help you Best regards ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: MY SON 6+MONTHS HAS BEEN SUFFERING FROM DISENTRY MORE THAN 15 DAYS. NOW BEFORE OR WHILE HE PASSES STOOL FEELING STOMACH ACHE. WE HAVE DONE A TEST OF URINE WHERE PUS CELL FOUND. WHAT HAPPNED TO HIM? WHAT SHOULD WE TAKE SEPTS FOR HIS EARLY RECOVERY. HE IS ALREADY UNDER SUPERVISION OF A CHILD SPECIALIST. KINDLY ADVISE. ### REPLY: Hi, 1. What is the exact date of birth?2. What is the birth weight and current weight?3. What is the current length?4. Does the kid have any unexplained vomiting?5. Does the kid have intermittent or recurrent diarrhea?6. Does the respiratory sounds increase during feeding or sleeping?7. How is the attaining of developmental milestones?8. Is the stool oily and floats in the pan?9. Is there any color change in the hair or skin?10. Is there any history of recurrent serious infections? Hope I have answered your query. Let me know if I can assist you further. Take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have been experiencing stomach cramps for over 24 hours, they are quite severe at times and fade away completely at other times, I am also experiencing nausea with them which appears to increase when I eat. The pain is in the upper abdomen and seemed to ease a little when sitting, although I find since eating this is not the case. ### REPLY: Hi ! Good evening. I am  answering your query. This could be due to some kind of food poisoning if you ate from outside your home. I am not aware if you do smoke or .  In that case you should get an ultrasound done and some routine blood tests along with a serum lipase and amylase to rule out pancreatitis and gall stones. If I were your doctor, I would advise you for an ultrasound abdomen followed by a CT if need be. However, all this would be preceded by a physical examination and some other investigations if you need arises. Till this time, you can go for a proton pump inhibitor  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Dr.,me and my girlfriend was masturbating each other and before i touched her vagina,i pulled down my underwear so im worried that some pre ejaculate sperm may get on my fingers,so i used a hand sanitizer and rub it,and then wipe it on a plastic bag.No penetrations are occurred here,just rubbing,help can by any chance she get pregnant and what are the chances ### REPLY: Hello, I just read your query. Pregnancy can not occur without penetrative sex. When penis penetrates into vagina and semen ejaculated in female partner, only then pregnancy occurs. *The ovulation time period of your female partner also matters.*But if you are still in doubt, then wait for the periods to come. If they come on regular time then there is nothing to worry. Otherwise, you can go for a urine pregnancy test if periods does not come regularly.* I hope you find my answer helpful. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am type 2 non insulin diabetic and made very poor choices in food this evening. Just checked my glucometer and reading was 414. Took my vyctoza injection of 1.2 mgs right away. I am not having any symptoms at the moment, but it is bedtime and I cant go to sleep with this reading on my mind. Am I in danger of going into diabetic coma with this high reading? Is there anything I can do at this moment to counter act this reading? ### REPLY: Hello, For now, if you don't feel any symptoms of hyperglycemic coma then don't worry and do these things. Since you took your Liraglutide injection at evening time, you can check your blood sugar again and if this is in the normal range, that's fine. Usually, type 2 DM with BS of 400 mg/DL doesn't do anything acutely so relax and just monitor the sugar and keep yourself well HY . 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: My pediatrician used silver nitrate to treat my two week old son s belly button, which had a small amount of drainage, after the cord fell off. Now there is still drainage and the skin around the belly button is discolored (a grey to purple color). I also noticed a purple discoloration to the top of his penis. It appears that the top of his penis touched his belly button and got silver nitrate on it. Should I be concerned? ### REPLY: Thanks for putting up your query at . I understand the cause of your concern. Silver nitrate is safe and if it touched the penis, there is no need to be concerned. But the cause of purple discoloration of the top the penis is not clear from the description that you have provided. I suggest that you consult your pediatrician about this. A discolored bellybutton, usually blue or purplish, is often caused by an umbilical hernia. But that is normal in newborns, and you need not worry as the condition generally gets corrected on its own. Information about whether the baby was born preterm would have been helpful. I hope that helps. Feel free to revert with further queries if any. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 stomach feels like theres bubbles poppin and it makes noises allll the time! like everry minute! it even makes noises at the top of my stomach where the rib cage starts and everything. My stomach hurts sometimes too like theres a stitch or a sicky feeling. i dont have any poo problems but these noises are so embarsing when i have to sit in silence for a test or something. how do i get rid of it or what is it? ### REPLY: Hi. Thanks for your query and an elucidated history. The noises the stomach make is called Borborygmi and the probable reasons can be as follows:-Intestinal obstruction-Aerophagia causing excessive gas -Intestinal infection causing gas formation-Anxiety and stress add on such problems would advise you the following:-X-ray of the abdomen in standing position.-CT scan of the abdomen with double contrast TOI find for intestinal obstruction / mass/ cancer etc.-Routine investigations of the stool, urine and blood to rule of thyroid, live problems further treatment will obviously be based on the findings ... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 pls wat are my chances of geting pregnat wit dis result.... LH;26.MIU 15 ,FSH:22.4MIU 10 ,Prolactin:3.5ng|mi(2.39.15 . Tesosteron:2.0nmol|l(0.2---4.4. E2:287pg|ml(13-191 TSH:11.7 IU|ml(0.4-7.0. as it is now no menses since 6 jan 2012. drug taken now ....bromergon and carbiroid. age 38 by decmber tanks ### REPLY: helloWelcome to  From your tests - it suggests that you have a condition called hypothyroidism and require treatment for the same. As you did not get a cycle from Jan 2012 - it will be advisable to get a pelvic scan done which can give some idea on your condition Additional tests to look at the ovarian reserve can be performed and then a conclusion on the chance of falling pregnant can be decided your consultant will be able to help you with the same hope to have answered your query wish 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 m 30 yr old boy from lidhiana( punjab) i had a prob on my face before 15 days ago i had chiken pox .now mostly chicken pox is finished bt i have so much black dark doats my face or my body.now i m using sun cross aqua gel ( ranbaxy Company) with 1 tab of limcee daily ..pls give me suggesion wt mdi i can use to remove all dark doats ........pls i will very thank ful to u plsss ### REPLY: Hello and Welcome to , Thanks for writing to us. Vitamin E, known for its healing qualities, helps nourish skin and fade scars. Open a vitamin E capsule and apply gel directly to the scars twice a day until you see them start to fade, then apply once a day thereafter. Eat foods rich in vitamin K. These are good for your skin because vitamin K helps heal and protect skin from wounds and scars. Slice a fresh lemon and brush across your chicken-pox scars. Coat chicken-pox scars liberally in honey once a day. Rub raw garlic on your chicken-pox scars at night. If your scars are new, rub sandalwood oil on them. Do this for a few months, and you just might prevent your scar from setting in the first place. If your scars are very old, rub coconut oil on them every morning. Hope this helps you. Wishing you good health... Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: On my very last stair on the staircase in my house, there s a wooden part. I was running up the stairs and tripped and hit the top on my shin (tibia) on it. I must ve hit it pretty hard bc after, I could barely walk. It s about an hour later and it s still hurts. I walk funny, the place where I hit it is all swollen and hurts to the touch. It s hurts a lot when I walk on it too. In icing it right now. Should it be okay? ### REPLY: Hello, I have studied your case and I think that there is soft tissue injury there. You should not be worried about this as all this will improve with in three to four day. You need to apply ice and take painkiller like Govern. Also apply compression bandage. This will take care of pain and inflammation. I hope this answer will be useful for you. Let me know if there is any other followup questions. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello doctor my name is Suriya (girl) 22 yearsold from india,tamilnadu i was losing my hair from last 4weeks due to typhoid i dont know which is proper way to avoid  hair loss and make my hair grow as healthy i had used almond oil massage and other oils, its no use. can u tell me proper way to make it growth well?please get me proper prevention to my hair ### REPLY: Hi Surya, You seem to have halogen effluvium .you are right...it may be post enteric (typhoid)halogen effluvium. You may be having some other causes....like anemia, vitamin and nutritional deficiencies, thyroid dysfunction, stress, anxiety, worries,travelling, any other internal disease, certain . .etc. Poor hygiene and poor nutrition may be responsible for halogen effluvium. You consult dermatologist for firm diagnosis. To control hair fall and to improve hair growth you may take biotin 10 tabs daily for few months and apply mild steroid lotion on scalp at night daily. For hair oiling and shampoo use herbal preparations. Take treatment for few years. Have patience.for the good result. I hope this would help you. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, may I answer your health queries right now ? Please type your query here... hi, my daughter is 9, and i found a hard knot on her upper thigh. i am very scared, and she says it doesnt hurt, unless i touch it. what do i need to be concerned about? ### REPLY: Hi.based from your description, it could be any of the following lesions: cystic formation, fibrous or lipoma. Other tumor types must also be ruled out especially in her age. It is best if you consult with a doctor, preferably a pediatric or a general surgeon, for clinical evaluation. Diagnostics and management (medical and/or surgical) will be directed accordingly. Hope this helps. Good day!!~ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am 48, white female, 61" tall, 150 lb.  Lobular carcinoma was found in the left breast which was stage II.  I had a bilateral simple mastectomy. I have several spots in the lungs and liver.  I completed 16 chemo treatments.  I had an EKG which was good, no respiratory problems.  I had one area in the lungs shrink after chemo treatments, but another "hazy" area appeared.  What could be the possible cause of the hazy areas? ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You have breast cancer.  It is of stage 2. So spots in lung and liver are not due to cancer.  Because if they are cancer spots then your cancer become stage 4. You should go for ct scan of chest with contrast.  It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just had a ct scan on some lymph nodes is my neck the report said can be reactive nodes, maybe lymphoma or occult squamous cell maligancy of the face and neck. my doctor is ordering a biopsy. things are scaring me but my doctor does not call he does not explain what is going on. Im so,scared and alone. Will they have to cut my neck and face up?? The nodes are like marbles but they more if you use your finger. HELP. thanks. ### REPLY: HI, Thank for choosing ChatDoctorTwo things are very clear, in your case first if nothing comes out in biopsy report then you are lucky, if something came out, then it will be treated accordingly in early stage, again there is something which bothers both the Doctor and to you, then why not to differentiate it or clear the doubts, so need to fear a biopsy, every thing will be alright, just go ahead, Have Nice Day. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Dear Doctor, I m pregnant in 28 gwk. I had Ultra Sound (US) scan and they report the my baby have Left Ventricle Brain Prominent = 0.76 cm and his head circumference = 25.7 cm. I m worry if my baby will has any problem (e.g. Hydrocephelus). What s your opinion? Thanx in advanced.. ### REPLY: Hi, .  I welcome you to  VIRTUAL CLINIC. I have gone through your question, and I think I have understood your concern. Furthermore, I will suggest you the best possible treatment options. 1) First do not worry. 2) A single scan report is not conclusive, repeat the scan after 4 weeks.  Also, it is important to know pressure effect of enlarged ventricle on the brain. This is cerebra ventricular ratio. If it is not growing in size and there is no pressure on brain, then you need not worry. 3) it will be helpful to consult with fetal medicine expert in your treating hospital.  There are many solutions even if the babies ventricles have problems.  The problem can be tackled by neurology experts. I hope this answer helps you. Thanks  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A friend of mine fell off a high ladder while putting up the Christmas Tree. She fell off, and hit the couch and bounced off that and hit something else. Her left leg swole up some and is in a lot of pain. She has been putting pain patches on it however this being the 4 or 5th day, she is still in a lot of pain, and insists that it will just take time for the pain to go away. She can t stay off the leg too much because of the work she does. She tries to elevate it when she can. What can she do to relieve the pain in her leg? ### REPLY: Hello, Your friend may have a muscle injury or a mild fracture if she had a hard hit. She should do following to have relief:- If possible get an x-ray done to rule out any bone injury-Apply an Ace bandage over the leg from below upward, from foot to above the knee.-Do not rub that area-Take a good analgesic like paracetamol or diclofenac on prescription with your doctor Hope I have answered your question. Let me know if I can assist you further.  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi I m sumaira 34 years old.. Married 2 years ago. I wana conceive ..had lots of ovulation induction madicens. N my mid ultrasound quit clear n it was 2.1 . But I can t pregnant. This month again my dr gave Ivf injection on 4th dy of periods . Is it ok to hv injection on 4 day of period ### REPLY: Greetings. For ovulation induction different protocols are there. It will depend upon on your hormonal levels and other factors. Since you have not mentioned your causes of infertility it is difficult to comment.However, if you have taken more than 5 to 6 cycles of hormone injection it is better to evaluate further before taking hormones for ovulation induction. Hope husbands semen analysis is normal. I can help you if you provide some more details. Hope my answer helps 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 have the flu at the moment and my heart is beating 110 beats per minute! But I also have dilated cardiomyopathy which I have medication for! And Atriil fibiration! When I rest it seems to be ok but when I get up and move around my heart beats quite fast?? ### REPLY: Greetings. Welcome to , and thank you for your question. I understand your concern. Usually, during flu and other infectious issues in the organism, that are accompanied by fever, there is a hyperkinetic state and the organism has to regulate itself to cope with this strain. One of the compensatory mechanisms in hyperkinetic states is the rapid heart rate. Furthermore, the center of temperature regulation in the human body is settled in the hypothalamus, the highest regulator in the brain. Due to this engagement, also the heart rate goes up. As for the other concern, that heart beats fast when moving around, in case of dilated cardiomyopathy, it is accompanied by heart insufficiency. This insufficient heart cannot cope as easily as a normal heart with a workload put onto it. Therefore, also here, the heart rate compensates as much as it can, for the strain put onto the heart. To illustrate it more figuratively to understand it more clearly, imagine the heart is a donkey, and an enlarged heart is like an old donkey, and it is clear that the two donkeys cannot cope in the same way with the same loads put on their back. As about the atrial fibrillation, I would need further information to ad .  However, if this is an enlarged heart caused by ischemic reason, then an antiarrhythmic such as amiodarone, would be appropriate to treat or prevent this supraventricular arrhythmia. I hope I was helpful with my answer. Feel free to ask again. 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: For a week now I have had a gnawing, uncomfortable feeling in my stomach, especially after eating small amounts of food. This occurs maybe half hour or so after eating. Its pretty much been constantly there for the whole week. I stayed home after the first day because I thought I had a stomach flu, but it s continued all week. Nighttime is very uncomfortable. I had a meal replacement drink because I was afraid to eat a meal but the pain and fullness feeling still came shortly after. No matter how small amount of food or drink I have, the full feeling and sharp pain still occur. Can you help me? ### REPLY: Hi Most likely you are suffering from Acid Peptic Disorder. You need to take simple soft diet without spices. Antacid suspension/gel containing tetracaine 10ml 4 times daily before taking food with Proton-pump inhibitors (PPI's)- omeprazole 20 mg, pantoprazole 40 mg, omeprazole 20 mg in the morning empty stomach will be helpful. If needed you can take extra dose of Proton-pump inhibitors in the evening empty stomach. Instead of Proton-pump inhibitors, you can take H₂ receptor antagonists - renowned brand Sanitizing (common brand name Santa by Glaxo) 150 mg morning and evening empty stomach may be used. RegardsRanjit ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 doctorMy father is facing problem of kidney impact.cretinine level was 3.8 when checked first time, its 2.6 right now. its in initial stage. we are currently checking with AIIMS Delhi, certain test has been done and some are still going on. As per doctor there was impact on kidney due to diabetes. i need to know what can be the solution to recover the kidney fully.He is ok right now but having weakness , sugar level is also not very high and BP is under control.we need very good specialist for consultation. ### REPLY: HelloThanks for query. Your father who is known diabetic and hypertensive has been detected to have raise Serum Creatinine levels (3.8 and later on 2.6) Raised creatinine levels suggest what is termed as Diabetic Nephropathy (Deranged kidney function due to Diabetes). This is irreversible process and has to be under supervision and guidance of a qualified Nephrologist. Following general measures will help to keep the creatinine levels well controlled .1) He should have salt free diet with fewer proteins 2) Avoid meat or non-vegetarian food .3) Proper control of diabetes with frequent monitoring of blood sugar levels .4) Proper control of hypertension with . 5) Have moderate exercises or Yoga's suitable to his age .6) Regular follow up and check up by Nephrologist or a Physician. These measures will keep his creatinine levels well controlled and will avoid further progress of kidney parenchymal 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 have a heavy head almost as if it s filling with blood. I also have shortness of breath an I don t want to say chest pressure but it feels like I have flem caught in my chest. I also have a pain in the crease of my shoulder blade when I take a deep breath an sometimes the pain will move to the front in my rib area. What could this be? ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of bronchitis is more likely. Bronchitis causes bronchospasm and this in turn causes chest tightness, breathing difficulty, coughing etc. So better to consult pulmonologist and get done clinical examination of respiratory system and PFT (Pulmonary Function Test). PFT will not only diagnose bronchitis, but it will also tell you about severity of the disease and treatment is based on severity only. You will need inhaled bronchodilators (formoterol or albuterol) and inhaled corticosteroid (ICS) (budesonide or fluticasone). 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 6wks pregnant according to my lmp, i hav had a tiny amount of spotting/bleeding in the last 2 days, but i did have sex for the first time in over a wk before the spotting occured. my doc sent me yesterday for an internal u/s and there was both sacs but no fetal pole or heartbeat? am i going to miscarry?? ### REPLY: Hallow Dear, At 6 weeks of pregnancy, if only sac is seen without fetal pole and heart beats, it means that there is no viable baby inside the sac. Such condition is known as Blighted ovum. This pregnancy would not grow. Therefore, the uterus is now trying to throw out the products of conception causing some spotting. This spotting would not be due to sexual intercourse. If within a couple of days you do not abort naturally, please get the abortion done from a Gynecologist as this is a non-viable pregnancy. Take care please, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 does white spots on a hida scan indicate in a 9yr old boy? ### REPLY: Hi Elizabeth. I will be glad to answer your query.  (HIDE scan) is a nuclear imaging procedure to evaluate the health and function of the gallbladder. A radioactive tracer, usually technetium-99 m, is injected through any accessible vein, then allowed to circulate to the liver, where it is excreted into the biliary system and stored by the gallbladder and biliary system. In the absence of disease, the gallbladder is visualized within 1 hour of the injection of the radioactive tracer. If the gallbladder is not visualized within 4 hours after the injection, this indicates either cholecystitis or cystic duct obstruction.  So it depends on the time at which image is taken. Diagnosis also varies according to the variation in image n the time of taking an image after injection of radiotracer. So your radiologist who did the procedure n saw the images of hide scan can answer your question better. I hope this will be helpful to you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: While getting dressed this morning I had a sharp pain in the upper right side of my chest.  While it lessened after I belched several times, Ive had lesser pain on and off all day, which radiates from the right side of my chest to my mid back.   Belching does seem to relieve the pressure, but the paid doesnt go away.  Any suggestions? ### REPLY: Hi welcome to the  Here pain is right sided abdominal not severe enough and not on left side It can be from referred pain of gastritis or chronic constipation It could be musculoskeletal pain if no obvious cause found and pain aggravation by some movement. According to cause specific treatment given For gastritis antacid like pantoprazole prescribed Here EKG also done to rule out cardiac cause although seem less likely If abdominal pain associated than USG done Take care Consult physician for examination ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello. I am a 21 year old Male and have all 4 wisdom teeth in. The bottom right has an issue. There is part of the cheek/gum that still hangs over it and it hurts like sin... I was told it would eventually recede but has not yet. What are my options? ### REPLY: Helloo...after reading your symptoms I can say that it is peritonitis(inflammation of periodontal flap).but don't worry .its just usual...u have to do HY . .take antibiotics(amoxicillin+metronidazole) and analgesic(diclofenac).do warm salt water gargle as many times as possible.meet an oral surgeon and get it extracted(if not erupting).then it will get healed...hope your benefitted something from this reply.have a healthy day!!! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: It seems like when I lay completely flat on my back for longer then ten minutes when I try to get up I have a sharp pain in my lower back which causes me to be unable to get up. The pain normally goes away after 10-15 minutes, however, it has lasted up to two hours. ### REPLY: DEAR FRIEND, I UNDERSTAND YOUR CONCERNS ABOUT YOUR PAIN. SEE THIS IS MAY BE DUE TO MUSCLE STRAIN OR NERVE COMPRESSION, SO WE NEED TO TAKE CARE OF BACK... SEE IN THIS TYPE OF CASE PAIN IS THE MAIN FACTOR WHICH TROUBLES HIM DUE TO IRRITATION OF NERVE ROOTS. NO NEED TO WORRY, YOU NEED TO TAKE IT AND TRACTION THERAPY FOR HIS BACK IN PHYSIOTHERAPY CLINIC... IF ANY LOCALIZE PAIN IS PRESENT THEN TAKE ULTRASONIC THERAPY.... YOU NEED 15 days TO THIS THERAPY!! THEN ONLY START WITH VARIOUS EXERCISE... TILL THAT TIME WAIT FOR PAIN TO REDUCE.... ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hello I have a pain in my buttcrack, I went to the doctor and got it checked out she told me it wasn t a cyst she think I hit my butt onto something. and I know I didn t. She told me to take a hot bath 2-3 times a day and to take Tylenol every 6 hours. And if it still hurts come back to take an xray. the pain stiiilllll is here nothing is helping!! ### REPLY: Here you need to check whether the pain is from lower back to buttock or only in buttock.  Or close to hip.  Based on that do take x-ray and I believe physical therapy or physiotherapy to will be helpful for you so visit a Physiotherapist to.  And do ask them some exercise for buttocks apart from regular treatment they give.  Also, if done with spinal exercise great. Hope it was useful for 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: hi back in april i had a pap done and thought every thing was fine but little did i know that i had hpv stage 2 now didnt find out till 3 months later...on 6/25/2011 i had to go to the hospital and got some test done now am not sure what they mean ( epithelial cells 3) wbcs ### REPLY: Thank you for asking on ChatDoctorA Pap smear test result HPV stage 2 means you have been diagnosis for cervical intraepithelial neoplasm (IN) with moderate dysplasia confined to the basal 2/3 of the epithelium, a pre-cancerous state due to infection from Human Papilloma Virus (HPV) Treatment is to remove the abnormal area of skin. Based on data studies 95% of women will be cured with one treatment, but 5% may have further abnormalities and need another further treatment. Good luck. Kindly rate my answer as helpful. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 found a lump in my groin area that hurts when rubbed by myn panties.  Seems to have lost some fluid and gotten smaller, but still cinvcerned.  Have doctor appt. 9/12/17.  Could it be a cyst or large pimple?nkeeping doctor appt. , couldnt get earlier one. ### REPLY: Hello rearward welcome to .come have evaluated your query thoroughly.* This seems more of sebaceous cyst, boil or other lesion needs clinical evaluation or at least a photo pic for better judgement to guide precisely.* Current recommendations - Keep the part clean with antiseptic liquids, . - Apply dusting powder clotrimazole (1 %) 3 times a day.- Analgesic as and when required. Hope this will help you for sure. 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 there, my step dad is being treated with hypertension. I am a student midwife and interested in becoming a doctor so have given some advice but yesterday apparently his bp was 150/100 using home monitoring. He has seemed unwell and had pain in ?kidney ? intestines region (I wasnt there) he only has one kidney aswell. (born that way). WHen he monitors his BP at what bp should he ring the doctor? ### REPLY: Hi, Welcome. Bp above 140/90 mm Hg is considered abnormal & should be treated. Having a single kidney can be a cause for high BP. Pain can also increase the BP temporarily, whicChatDoctores down as soon as the pain is gone due to sympathetic stimulation. Have his KFT (kidney function test) done & monitor the BP regularly. If it persists to be higher than either the medicine need to be escalated or a new . 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 have been using Qlaira birth control since August. I take them at the same time everyday. I had my period at the right time in September but did not get my period in October. I have taken sinus medication (over-the-counter stuff) and have not used an antibiotic at all in the past month. Is this a normal side effect of the Qlaira birth control pills or could I be pregnant? Thanks ### REPLY: Hello, Absence of the menstrual period can happen as a side effect with the use of oral contraceptives, but, this must be reported immediately to the consultant for further management. Not only antibiotics, but, some other medications like carbamazepine, topiramate, ketoconazole, cimetidine etc., also can affect the pharmacological action of hormones. Also, additional protection is needed in the first couple of months after the use of oral pills to prevent failure. You should exclude pregnancy through the blood test before moving on further. Hope this helps. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am suffering from Jaundice with Hepatitis A. Is there any difference between normal jaundice and Jaundice with Hepatitis A? What is SGPT and SGOT test in Jaundice? Is it OK for me to intake salt in my food? Also can I consume both Ayurvedic and English medicines together to cure Jaundice? Please answer my queries... ### REPLY: Hi, How are you? I am so sorry to hear about your symptoms. Jaundice can be caused by a variety of reasons including infections, alcohol, some blood diseases and also metabolic diseases. The cause of the jaundice also varies with different age groups. Hepatitis due to viral infections are very common. Among the viral infections, Hepatitis A and E are transmitted by contaminated food and water. Hepatitis B, C and D are transmitted by contaminated blood and body fluids. The good thing about hepatitis A and E are they cause a self limiting form of hepatitis in the majority of people. It causes a brief period of fever, nausea, vomiting and maybe GI upset with the jaundice, but it goes away spontaneously without any treatment. In a small minority of people (like in pregnant women) these can cause a severe fulminant liver failure. Once the liver gets damaged, the enzymes stored in the liver cell gets released into the blood and this will lead to an increase in the levels. The GOT and SGPT levels go up for the same reason. A decrease in the level of enzymes reflect improvement in the liver status. Regarding treatment of hepatitis A, I am not knowledgeable in ayurvedic system of medicine. So I cannot guide you regarding ayurvedic medicines, but there are a lot of liver protective supplements available in the allopathic ("English") system of medicine and I would advise you to take those. As long as you avoid fatty foods during your acute phase of jaundice, salt intake should be of no concern. Hope this helped and hope you start feeling better soon. Please do not hesitate to contact me for any further clarifications - rxsuresh@gmail.com ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi....I am a 44 yr old woman! Ive been feeling very, very tired lately, with chest discomfort and sometimes pain in my chest.  I burp  a lot too!  I notice that these symptoms come more after I eat.  I am a smoker.  I informed my doctor and she made me pass a stress test for my heart, everthing was good. ### REPLY: Thanks for your question on . I can understand your concern. By your history and description, possibility of HERD (gastroesophageal reflux disease) is more likely. 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 burping, chest tightness, pressure etc. Smokers are more prone for HERD. So first stop smoking immediately. Start pantoprazole and levosulperide combination twice daily on empty stomach. Avoid hot, spicy and large meals. Avoid stress and tension, be relaxed and calm. Go for walking after meals. Don't worry, you will be alright with all these but first quit smoking. 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 son, age 42 son had a Tibial Plateau Fracture in October at work.  Screws, plates, etc. Released to go back to work about a month ago.   comes home from work and has to icehis knee.  swelling... pain.    Is this normal?   Or could he have some knee damage too? His Doctor says this could take a year of pain.  I can see maybe a year to fully recover, but a year of his knee hurting?  Ideas? ### REPLY: since 6 months have elapsed after surgery, I believe your surgeon may have assessed the screw plates by a check x-ray and condition of bone. Usually some swelling may come off and on, but tenderness and pain should lessen now. If there is loosening of screw, delayed bone union or infection of bone (osteomyelitis) or metal ions allergic reactions locally, there may be persistent pain. A bone scan for infection of bone is usually required to diagnose bone infection and metallic ion levels for material of implant used for metal reactions. Your surgeon will assess all these if he thinks necessary ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have a 4 months old baby who is very floppy. He can lift his head and chest for sometime during his tummy time, however, when I lift him in an erect position he has a poor control over his head. Also, his body is not firm and seems very floppy. He is actually 4 months 1 week. He rolls over both the ways. ### REPLY: thanks for asking I have gone through your question and understand your concern. Your 4-month-old boy has poor control over his head. And he is able to rolls over both the sides. Baby start to learn to control his head form 3 months of age. And in 5-6 month he had good control over head. His other milestone like rolls over is at right time.I think he should have his good control as he reaches 5-6 months. Baby bodies initially is not firm is very floppy. I think i able to answer your query ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: From my upper back down to the back of my legs, I have small red bumps cropping up. I didn t notice until a few days ago since it s only along my back. They re not itchy nor painful at all. They re just there. Some of them look like they re just caused by ingrown hair . I don t think it s an allergy because my diet has stayed the same and I ve also lived in the same place for years and the only allergy i know that I have is to penicillin . ### REPLY: These are acne pipes as the acne can attack face or back of skin avoid oily Reese fat woodlot of warm water non-toxic soaps shampoo and oils no creams apply clindamycin gel band retinoid acid gel at night on affected skin switch off lights it seats with lightebastine 10 mg SOS for itch no use of penicillin group of salts no broken PCM diet supplements vitamins calcium as they trigger skin allergy and acne ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My husband and I have tried sex and our main concern was to get me pregnant. But whenever we had sex I see that he is not able to insert it properly and I have heard that it is painful. So kindly suggest as to how much of penis has to be inserted inoreder to get me pregnant. ### REPLY: Hello dairy understand your concernPenetration up to vaginal introits/entrance is sufficient to become pregnancy. But more the deeper penetration, more chance of pregnancy. Penetration does not cause pain every time. Once penis enter into the vagina easily then chance of the pain is less. Pain could be due to: Vaginal . I would suggest consulting the gynecologist if you have pain during intercourse if you will face the pain. Take following advises:Use K-Y water based lubrication gel use vaginal moisturizing agents like VAGINAL after bathing Spend more time in the foreplay before the semester the penis very slowly and then tell the partner to go forward till you do not feel the pain. Maintain proper pelvic hygiene regular exercise like pelvic exercise, walking. Take healthy diet and  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hello, My name is Henry, Im having lots of trouble with my mind worrying all the time, making bad decisions, cant keep a job, my marriage is been off because of my problems, cant concentrate, not attentive, not sociable and have no feelings in getting motivated to do tasks.  Ive been going to doctors for over 20 yrs and not one of them have done tests. They just guess and say here try this medication, if it soesnt work well try another and another and so on. Been taking Ritalin for 3 yrs, 20mg twice a day. I tell my doctors that if I take 20 mgs 6 of them seperately doing the day I feel absolutely fantastic, Im sociable, more confident, attentive, and make better decisions. but 2 20 mgs a day just dont do it. AT ALL! I take 3 in morning everything is great until 2.5 hours later. THey wear off and Im back to being aweful, So I take 1 for another hour then 1 for another hour and 1 for another hour. That seems to work really good. But that is like overtaking my meds that were prescribed to me. Why cant they just prescribe me 3 40 mgs a day? I want to be better after all these yrs of taking off the wall medicine that dont work. but dont want to over  tale whats prescribed to me. Adderal is aweful, and so is dexedrine. Ritalin LA and RA makes me wired and jittery dont work at all. Can someone please after all these yrs help me? In my opinion I need tests run brain and blood work, but havent in 20 yrs had any. I asked them too, but they say no u dont need tests. ### REPLY: Dear Henry, Thanks for using . Your doctors are absolutely right in saying that you do not need any tests. At the same time I think you need some behavior therapy to counter your symptoms. It is difficult to predict what is going to work for you, but I guess that even the low dose Ritalin can help you to the large extent if behavior therapy given along with this medication. It is also possible you may not need medication if you get good results with behavior therapy. This is a bitter truth that you need to take Ritalin unless other measures of helping you are not tried with almost seriousness. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Im 63 years old been diagnosed with leaky heart valves and pericardial effusion waiting for cardiologist appointment. Off sick for last 3 days palpitations light headed, nauseous, breathless on exertion, have been taking my bp and it varies between 106/60 -148/98 pulse 52-110, can you advise please? ### REPLY: Hello and thank you for using . I carefully read your question and I understand your concern. I will try to explain you and give my opinion. You should know that this palpitation is related with a rhythm issue. They are electrical impulses that generates in parts of the heart different from normal sinus rhythm. They cause premature heart contraction, and you might experience palpitation, flattering sensation, anxiety, difficulties in breathing deeply, dizziness etc. The causes of this rhythm issue might be different to simple emotional stress or pathologies like anemia, hyperthyroidism, electrolyte imbalances, cardiovascular disease, valvular problems, active infections or pericardial effusion. So, in your case it is mandatory to evaluate the severity of valvular problem and pericardial effusion. They might be the main reason of your palpitations, breathing difficulty etc. According to blood pressure values you should know that we talk about hypertension if we have mean values above 140 / 90 mmHg. A person might have high value during stress, so it is mandatory to judge on mean values. Treating the causing factor improves all the associated symptoms. So, if I was your treating doctor I would recommend some examination like a cardiac echo, a full blood analyze, your thyroid hormones and a holder rhythm and pressure monitoring. After all this we can judge and know how to treat the problem. 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: hey doctor my brother esr test so high 125 level start last 9 months first test is 58 then 90 ,92 and now 125 his spinal operation 28-11-2006 and cage fixation carries 7 8 he fit last 5 years and use medicine MYRIN P AND VITA 6 18 MONTHS NOW HIS CONDITION VERY BAD SO WEAK COUGH AND FEVER HB%9.3 AND MRI TEST IS CLEAR X-RAY SPINAL IS CLEAR BUT EST TEST IS INCREASE DAY BY DAY CHEAST X-RAY ALSO CLEAR CBC TEST TOTAL RBC 3.6 HCT 30 MV 82 MCH 26 MCHC 32 PLATELET COUNT 494 WBC COUNT ( TLC )9.5 NEUTROPHILS 87 LYMPHOCYTES 07 MONOCYTES06 ### REPLY: Hi, Thanks for query, Erythocyte sedimentation rate or ESR has no diagnostic value, but it is used to measure prognostic value. High value then normal indicates presence of disease, but its rising value indicates that the disease is increasing while compared to previous low value indicates that the disease is under control. It is sometimes found higher in tuberculous infection but as in your case Lymphocyte shows only &7% indicate presence of Tuberculous infection is under control. The use of Marin P should be supervised by a physician. 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: doctors suggested my wife many a tablets for brain TB. rcin 600, levera 500 + 250, benadon, calcimax750, pzide 750. any one or two more. i want to knw is she is taking right medicines n she is four months pregnant. my email id is  YYYY@YYYY . ### REPLY: Hi, Welcome to  .com I am . Mariano Into Bruno Mascaras. I have gone through your query with diligence and would like you to know that I am here to help you. The Best Medicine is DOTS as per RNTCP Guidelines. http://www.yyyyyyyyorg/rntcp/ Please consult the nearest Government Hospital Hope you found the answer helpful. If you need any clarification / have doubts / have additional questions / have follow-up questions, then please do not hesitate in asking again. I will be happy to answer your questions. In the future, for continuity of care, I encourage you to contact me directly in  at http://bit.ly/ask ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 has a urine dip in Dr office on Tuesday and they said there were minimal white blood cells in urine but not too concerned. Sent urine off to lab and received a call today that my 10 yr old sons urine culture came back that staph was found. He says this is not a common occurance and he want him to see a urologist. Any ideas what could have caused this?? ### REPLY: Hi.... with the pus cells in the urine routine being normal and staphylococcus growing in the urine culture, I feel that it is only a contaminant. You need not worry about this.Moreover, you have not said anything about high grade fever, pain in the abdomen, pain or burning sensation while passing urine and vomiting, which are the signs of urinary infection. So I feel that this is not a urinary infection and the urine culture is growing only contaminant. Regards -  ### END