Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Last night my husband bit me on my arm . I quickly got up and told him to stop. I really got scared i told him what he had done and that if he had realised what he has done. his response was yes . he then got out of bed and went to the toilet. At this point he really sh?? me up.That evening he was watching a vampire movie with lots of blood and guts. He does not sleep well. His bedtime routine is sleeping between 1am and 3am. He gets up for half 8pm. He s got a lot of stress . He speaks jiberish whiles sleeping and makes sudden movements. Once he was having a nightmare until I woke I m up, asking him if he was ok. I think I saved him from his nightmare. Can you please help and give some sort of explanation. Thanks kera ### REPLY: Hello Seethalkaursingh, The problem you have tried to describe, doesn't appear to a nightmare. Its closer to being a night terror. Please understand that sucChatDoctorplains are very common and increase at the time of stress. People generally don't discuss them as they don't cause any problem for themselves. Epilepsy / seizure disorder is another concern, and he should be investigated by an EEG.  There are many unanswered questions in your write-up. But one thing is for certain that your husband surely need some help from a psychiatrist. Please ask him to visit one who would like to explore many his areas. Hope this answers some of your questions. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I need some one to help me i think i might have cancer  i went to the er because i couldnt shake a cold my chest xry was great but the dr said to follow up on my blood work can you help my doctor has no bed side mannor lymph 25.9 lymph abs 3.o neut 7.1 wbc 11.4 also my bun is 7 my gfr is 51 my creiatin is 1.22 ### REPLY: Hi, dairy have gone through your question. I can understand your concern. Symptoms of caner depends on site type and location of cancer. Overall weakness, weight loss, liver spleen and lymph node enlargement are some features. Your complete blood count, BUN and creatinine report is normal. No need to worry about cancer from this. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My father was just rejected for kidney transplant as he is diabetic and on dialysis. The rejection was due to his heart being too weak at 35 percent function; he had congestive heart failure last year. He is 78 years old, but seems strong to me. What would be average expectations? ### REPLY: Hello, for a person to undergo renal transplant, they patient should be fit for the surgery to undergo. For that his diabetes should be well controlled, if hypertension is there then the BP should be well controlled. As for his heart condition where you specified his EF is only 35%, it is quite low. In surgery some time bleeding can occur in which state the patient undergoing surgery should have a heart strong enough to handle the blood loss and decreasing volume. As your fathers EF is only 35%, his heart won't be in condition to handle any situation occurring during surgery. So even if he appears to be fit to you, seeing his heart condition it will be inadvisable for him to undergo the transplant. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 recently become concerned about my heart. I m a 21 year old, 5 8, 175 pound woman and consider myself decently healthy. I eat well when I can although I do make poor food choices. I am also not very active as I work at a call centre and sit at a desk all day. I don t drink as much water as I should. I have also been smoking marijuana consistently for 6 years, mostly through a glass bong with at least 1 perculator. Within the last 2 years I have been smoking something called poppers , which is a layer of tobacco from a cigarette with a layer of marijuana smoked through a bong. It creates a strong headrush and intense feelings of relaxation, causing me to want to lay myself down as if it was overwhelming my body like heroin (I have never done heroin but I have seen people react that way to it before) I know it is very bad for me because the carcinogens from smoke is obviously bad, especially cigarette tabacco that s mixed with marijuana and only filtered through water, but I want to know what it s doing to my organs and body functions in the long run. The problem is that I don t think there have been many studies on poppers because it is a relatively new and still underground method of smoking marijuana so its hard to find reliable information. Recently my heart has been occasionally feeling strange. I will be relaxed either sitting or standing and breathing and I will breathe out slowly, then feel my heart almost lump up and beat in my throat, it scares me and I take a deep breath in to counteract it, and for a second I almost feel like its going to stop beating. Then its all good again. What s happening to my organs and why is my heart doing this? Thank you for taking the time to read this and reply! ### REPLY: Hello, The heart beats you are feeling is because of the ill effects of poppers on your heart as the tobacco would make the heart pump stronger and faster giving you the symptoms you have described.  As you have truly said that the effects op poppers haven't been studied however all the ill effects of tobacco applies here ranging from hypertension, stroke, heart issues, lung damage to various cancers. Also, the effect is compounded by weed. It's not wise to use poppers as the sudden surge in body metabolic is not good. 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 18th april11 the volume of pleural effusion was 192ml after drained volume 550ml.then after i am on akt4/ 3tab empty stomach/day.approx.3months have passed .last ultra sound on 10th june reported 110ml. still balance .what step to take further,as every day after taking medicine accute pain is still continuing in the whole body. ### REPLY: Hi Dear !! Thanks for your query to . Read and reviewed your query and health concerns. IN the given situation, You seem to suffer from-TB Lungs with Pleurisy with Pleural effusion. The pleuritic pains are very agonizing pains, as with each inspiration and expiration-the inflamed plural covering of lungs, rub with costal plural coverings. Pain Management of Pleuritic Pains with Pleural Effussions-Inj/Tabs-NSAIDs, Intercostal Neural blocks with Anesthetic -Xylocaine 2%and steroid addition in pleural cavities are the ways out to control these pains. Continued AKT till Pleural inflammation comes under full control is to be aimed in your case. This would take at least 3 more months, when your case needs to be reassessed. Continued Check -X-rays / ESR / weight gain checks/ high protein-high carbon/high fat diet, along with Multicity, It D3,B12 and folic acid would go a long way to come out of this pain soon. Hope this would help you to plan further of this complex illness of yours. If need be, update any health issue 24 x 7 by a direct question to ME, at following  link-http://doctor. .com/Funnel?page=askDoctorDirectly&docId=70229Dear, if satisfied, Dont forget to close this query with YOUR pleasing feedback comments to rate this reply and service, to boost the morale of incoming Emergency patients like YOU, at  services. If you want to update more details and ask more update queries, You are most Welcome herewith !! Good Day!! Wishing Good Healthy Life in time to come!! . N. Senior Surgical Specialist. S. Genl-CVTS ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 baby woke up with a very swollen left eye. He had a fever last night, runny nose and cough and I gave him some advil(has had Advil before), it doesnt seem to hurt him and there is no bruising, but its practically shut. Should i be taking him to the emergency room? ### REPLY: If one eye is swollen it can be simple inflammation due some infection of a layer of eyeball outer white--red eye , it can cause eyelids stick, child cannot open it until it is washed with warm water, however there are some other eyes diseases which need in time treatment I would recommend you .to consult doctor to examine his eye, suggest treatment, because some eye disease need urgent attention of specialist ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just was perscribed to adderall for add about a month ago and since then I have had my blood pressure taken twice, not by the doctor who perscibed me. Both times it has been high and I have never had problems before. Does it take your body time to adjust to adderall or should I be contacting my doctor? ### REPLY: Hello, Adderall increases BP, if your readings are persistently high then you need to decrease the dose of Adderall and if doesn't respond then need to be started on BP medicine.  But are you sure, you didn't have high BP prior to starting Adderall. You should visit the doctor.  You should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have low salt diet and monitor blood pressure regularly thrice a day for one week then once or twice a week. Regular exercises like brisk walking, jogging according your capacity at least 30 min a day and 5 days a week. Lots of green leafy vegetables, fruits, fish once or twice a week, avoid meat. Avoid smoking and alcohol if any. There shouldn't abdominal fat deposition or obesity. Get your lipid profile and sugars tested once. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 noticed a bright red spot above my canine. It looks like it might be a little pithed. It wasnt there yesterday and I dont recall that I injured myself with a toothbrush. What could this be? How long should I wait to see if it clears up on its own or to seek medical attention?  Im a 38 yr old female smoker that ironically is in good physical health and eats well. ### REPLY: Thanks for your query, I have gone through your query. The red spot above the canine over the mucosa could be a traumatic ulcer secondary to injury by tooth brush or any food items. The other possible cause could be stress resulting in authors ulcer formation. Nothing to be panic. If it is a traumatic ulcer or authors ulcer it will heal in 7 days time. If it is a traumatic ulcer or herpetic ulcer, you can take topical anesthetic and analgesics like Anabel gel. Apply 3-4 times daily before food. If it is authors ulcer you can take topical anesthetic and analgesics like Anabel gel. Apply 3-4 times daily before food and topical steroid like triamcinolone acetone 0.1% 4-5times daily after food. Do saline gargling 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: Hi My left arm has been paining for about a year. I cannot stretch my left arm to scrub my right side of the back. The pain started at the socket. It has spread through the arm and back of my hand to the fingers. Sometimes I have a burning sensation on my arm. Now my shoulders feel tired most of the time. I had an Xray done, but nothing showed. What could be wrong? Ruth ### REPLY: Hi, Thanks for your query. Due to compression of nerve root in cervical spine there is burning sensation and pain in arm. I will advise you to MRI cervical spine for better diagnosis. For these symptoms analgesic and neurotrophic like pregabalin and methylcobalaminmedication can be started consulting your doctor. Till time, avoid lifting weights, Sit with support to back. You can consult physiotherapist for help. Hope this helps. Let me know if you have any more concern. Warm Regards. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell on May 29 th.and landed on my knees. I am sure I did not break anything. The left knee swelled and I put ice on it and the swelling went down. it has been 2 weeks and I am now experiencing throbbing pain in both legs from the knee down. I am 75 and have not seen the doctor. Do you think this is serious. ### REPLY: Hello, I have studied your case. As per your age and history there is possibility of soft tissue injury in knee. Most commonly meniscus injury occurs may be associated collateral ligament injury. You may need to do MRI knee to see for any functional defect. As per your symptoms you need to do physiotherapy and knee exercises to improve range of motion. Rest and ice fomentation along with supportive brace will help to reduce locking episode and pain. Small meniscus tear can be managed conservatively with physiotherapy with USG and TENS. Large meniscus injury can be managed by arthroscopic repair. Another possibility of patellar ligament tightness which can be evaluated clinically. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi doctors im 25 years my husband and i have been trying for a baby tor two years now  with no luck my doctor put me on Fertomid 50mg this is my second cycle on it im taking it on day 5-9 and today on day 6 im seeing spoting is this normal no any other Side Effects three years ago we had a miscarriage that left us devistaterd should i be taking any vitamins with this medication i Dont know what to do i have a normal 28 day cycle my doctor siad if i  Dont fall  pregnant within three months then he will refer me to a Specialist any advise ### REPLY: Hi, Thanks for discussing your problem with us. Any women who are trying to conceive should take Folic acid. As you have had a miscarriage, you are suffering from secondary subfertility. I think you should have seen fertility specialist before trying any medicine from GP's. The best course of action for subfertile couples is to have full investigations first. Once a cause for low fertility is found treatment can be specific & targeted which is likely to be more successful. If this spotting is part of your periods, there is nothing to worry about. If you have finished your periods & again this started you should report this to your doctor. Wish you best of 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: My husband and I had intercourse and I was on top. I came down too hard and instead of penetrating me straight in his penis went in at an angle toward the back of my vaginal wall causing excruciating pain in my rectum and tailbone. Since then I have terrible pain in my tailbone especially when sitting or changing position from sitting to standing. It isnt getting better even with NSAIDS and intermittent ice to area. Is it possible that I couldve fractured my coccyx? Even having a bowel movement hurts the coccyx area. Im too embarrassed to go to the doctor and explain what happened. ### REPLY: Hello, I have studied your case. There can be coccyx bone injury or there can be rectal mucosa injury along with vaginal wall injury. For resistant coccydynia sacral local block injection may be helpful. Phototherapy [local injection] may also work for sacral pain. Consult your doctor for further investigation and clinical examination and injection. Physiotherapy like ultrasound and inferential therapy will give relief. I will advise checking your it B12 and it D3 level. Continue site bath and use of ring cushion. Hope this answers your query. If you have additional questions or follow-up queries then please do not hesitate in writing to us. I will be happy to answer your queries. Wishing you good health. Take care. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I ve had two low back surgery about 4 or 5 yes ago. I m 50 yrs old. Ever. Since I ve had the surgery my left leg goes completely numb with severe low back pain right where I had L5 and S1. Its gotten so bad I m afraid I m gonna be in a wheelchair in a couple of years. We timed me I can only walk 15 to 20 minutes. Till I have to set down with severe pain. Can you tell me what I can do I do go to pain management in Tulsa. But I m suffering. Help please. Their doc said there was nothing they can do for me but pain meds but it ain t doing it for me. I also was told today by my hubby its bruised badly where my pain is. ### REPLY: Hi, thank you for providing the brief history of you. A thorough neuromuscular assessment is advised. As you have a past history of operated spine two times, and now you are 50 and the doctors said they can't do anything. Do not feel sad, there is always a way, I will recommend you to consult a physical therapist, as by the help of him, you have to perform exercises to strengthen the muscles and get relief from aches and pains. Also, on a long term you will be able to walk as well. Physical therapist will understand your needs and the physiological demands of the body to get the functioning back. RegardsJay In .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I fell and injured the inside portion of my knee a week ago. My leg has bruised behind the knee area. However, what concerns me is that a couple of days after the fall, my shin became red and the leg below the knee is swollen. Could that be from the fall as well? I never injured the shin. ### REPLY: Hello, Yes, you are right. This is due to the injury to the knee. It is nowhere related to the shin. As you had a fall and this injury must have diatribes the internal structures of the knee leading to sprain and swelling. Taking up an x-ray will be always good for a safer side to figure out if you have any fracture. In most cases, it turns out negative, but we do have to understand that it is better to be cautious than ignorant. What I will suggest is to take up an x-ray if you can on a safe side. You can take hot water fermentation and keep the leg elevated over a pillow & perform ankle toe movements. This will help to allow a good venous return which will help to reduce the swelling and redness. Post this you can do some static Qua .  Using a knee brace will be of benefit for stabilizing the joint to avoid excessive pressure falling over the ligaments due to injury. In my clinical practice of over 12 years, most patients have responded well when precautions are taken and exercise is implemented with an intention to not allow muscle wasting 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: i got perminant crowns put on three days ago because i fell downstairs like four years ago and broke my front teeth...i got the nerves removed and the teeth filed down which didnt actually cause pain when the numbness wore off, however since ive had the crowns on my teeth have been in really bad pain, its so bad that when it happens i cant drink or eat, and its on and off pain throughout the day. Is this normal?? :/ ### REPLY: Hello, I went through your question. Pain after 3 days of crown fixation is more likely to be a high point in the crown. In other words, the crown must be interfering with your normal biting. Every time you bite, that particular crown comes in contact before the other teeth and hence more forces onto that particular crown. For this you definitely have to go back to your dentist and get it corrected. Otherwise the pain will not subside. Hope you will get better 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: I have a pain in my chest, feels like the sternum region, when I drink hot liquids (coffee).  My sternum region feels like there is a "bulge" or something in it that needs to be removed..no pain unless I drink hot liquids or eat a hot meal like oatmeal. ### REPLY: Hi. I can understand your concern. HERD (gastroesophageal reflux disease) can cause similar kind of chest pain. 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 central chest pain and nausea. You can take proton pump inhibitors. But along with .  Avoid stress and tension. Avoid hot and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Quit smoking and alcohol if you have these habits. Go for walk after meals. Keep 2-3 pillows under head in the bed to prevent reflux. Lose weight if you are obeseDont worry, you will be alright. Hope I have solved your query. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I have about five lumps under the skin in my right armpit, the first one that came is the biggest and around the middle then I have two at the top that are very small and the others range about the same size and are on the sides and bottom! I have always had very sensitive skin. But they are very sore, and I can only feel them not see them. ### REPLY: Hi, dairy have gone through your question. I can understand your concern. You may have enlarged lymph node. It can be due to reactive hyperplasia, tuberculosis, lymphoma or metastatic carcinoma. You should go for fine needle aspiration cytology or biopsy of that lump. It will give you exact diagnosis. Then you should take treatment accordingly. Hope I have answered your question, if you have any doubts then contact me at bit.ly/ . Thanks for using . Wish you a very good health. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I m a 14 year old male at a height of 70 inches and 155 pounds. In my lower left abdominal area, i get medium pain when i start working out. I noticed this happens more after after eating. It has enough pain so i can stop the work out. It happens around appendix area. It usually only happens when I workout after eating by 4-8 hours. ### REPLY: Hello dear abdominal pain after eating may be related to infection of colon usually by amoeba. Hence you may need stool examination for ova and cyst. You are also telling pain around appendix possibility of appendicitis can not be ruled out. For this you need ultrasound abdomen. If it is amoebic colitis antiemetic treatment is sufficed. If it turned out to be appendicitis you may need laparoscopic appendectomy. 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 hit my left thumb in the door while closing it. Initially the pain was unbearable the nail turned blue and black from base to half nail. its the 3rd day still have pain, radiating to left arm, throbbing and swollen at the base, with a slight yellow color. please advise ### REPLY: Hello, it may be entirely a soft tissue injury or displaced fracture may also be suspected depending on the severity of trauma. Yellow discoloration may be due to trauma related glycolysis, where the nail separates from the nail bed. Since throbbing pain is felt still on the 3rd day it's better to have a physical examination, an x-ray if required, along with ibuprofen...which relieves the pain and edema too. Hope it 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: sir I was travelled to bangalore by train and got down and i find some scales were fount in the foreskin of my penis and i got some irritation  after that my foreskin canot pull back and ifell pain while try to getback of my foreskin  I has not do any immorral habirt for the past twenty yers  but i have diabatic hoe this can be cured ### REPLY: HelloThanks for query. Inability to retract foreskin with itching and scaling is suggestive of fungal infection of foreskin what is called as Much Cutaneous Genital Candidiasis which is very common in persons with uncontrolled Diabetes. Please check your blood sugar levels to ensure whether your diabetes is under control or not. Take antifungal medication like Fluconazole twice daily orally along with topical antifungal jelly like Candid or Darryl for local application. Ensure to wash your genitals with warm water twice daily. Please note that proper control of diabetes is foremost important to resolve the issue. .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am on pradaxa - the new blood thinner.  I was diagnosed with erosive gastritis a year ago and spit up bloody sputum every morning when I awake.  It gathers in my mouth when I sleep, and shows only in am.  It seems to be minor.  The pradaxa keeps me from having angina.  I feel that I need to take it.  What should I do? ### REPLY: Hi, Thanks for asking. Based on your query, my opinion is as follows.1. Bloody sputum usually signifies, problems with oral hygiene.2. Meet a dentist for evaluation of gums, teeth or any ulcers.3. Prada, if it causes gastritis, and bleeding, it would have showed in stools, as dark-colored stools. 4. Presently Prada is not causing any erosive gastritis. Causes of bloody sputum appears to be in mouth. ENT and dentist evaluation will identify cause. Need to look for tumor too. Hope it helps. Any further queries, happy to help again. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: A friends family dog bit my daughters top lip today. It bled for less than a minute. I immeadiatly applied pressure with an ice pack and applied antibiotic ointment. It doesnt look deep at all. Lip is swollen. Dog is up to date on all vaccinations and rabies. Should I do something else? ### REPLY: Hello, Welcome to , Rabies is 100% fatal, but it is 100% preventable by proper and adequate treatment and this is transmitted by dog bite. As your daughter was bitten by a vaccinated dog over the lip which has led to bleeding from the site, according to WHO it is categorized into Cat III. Even it is a vaccinated dog you need to doubly check whether it is properly and completely vaccinated, because the bite is on the lip which is closer to the brain and the virus can ascend easily and reach the brain and can affect it. So I would suggest you to take 1. Active immunization with antirabies vaccine on days 0,3,7,14 and 28.2. Passive immunization with Rigs around the wound.3. Oral antibiotic like Tab Augmenting, twice daily4. Topical Tract ointment.Don't take any risk with this disease, I would suggest your daughter to take aforementioned treatment. 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 sometimes get a severe pain/cramp in my upper left abdomen, below my ribs.  The pain, like a charlie horse, usually occurs when bending or sitting in an awkward position.  Standing up helps the pain decrease, but if i sit or bend again the pain will return.  The cramp can last from seconds to minutes.  The area will remain sore and tender to the touch for hours or days.  I do not note any protrusion.  I am morbidly obese, have had various abdominal surgeries.  Could this be a hernia? ### REPLY: Hi. Thanks for your query. Read your history carefully and understood your problem. The commonest reason for the typical pain you have explained can be due to costo-chon .  In this condition the lower ribs get inflamed, remain dormant till the site is instigated - which in your case is due to bending. Once the pressure on it released the tenderness will go down. Noticing protrusion is very difficult in morbidly obese people. So we have to get help of ultrasonography or CT scan or an MRI-MRI will be the best as it will help diagnose the Costco ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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,ive been having hay fever for a while now,so today, this afternoon i felt my nose was full of cattarh and decided to blow it,immediately i got really dizzy,never felt like that in my entire life before, and before i knew what was happening i was on my knees on the toilet floor puking my stomach out, i can also hear my ear sizzling loudly, and now i feel really weak,please what is wrong with me? ### REPLY: HI, thanks for using  Sinusitis can be associated with tinnitus (the noise in your ear), dizziness and nausea. It can be due to allergies or infection. The use of a topical steroid nasal spray would be important to help with your symptoms. This includes medications such as alone, escort, Flonase, rhinoceros. In addition, oral antihistamines and decongestants would also help. Decongestants can be oral or topical. If there is no relief then it is possible there may be a bacterial infection that would require antibiotics 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: My daughter has a bite on her leg. I was wondering if we needed to take her to the doctor or if I can treat it at home. The area around the bite is a little larger than a quarter and red. It is also hard to the touch. It isn t hot. The actual bite area is oozing a very, very small amount of clear discharge. I ve given her Benadryl. She is two and a half years old and weighs 30lbs. I have given her two doses of Benadryl today (5ml) and the bite doesn t seem to have changed at all. ### REPLY: The exact opinion regarding whether you can treat it in home or whether you have to seek the help of doctor can only be given only after having the visual impression of the wound. But as it is not possible & considering the symptoms narrated it would be appropriate to have physician visit who will direct you regarding medications. Considering the narration my opinion is that you may require to add oral antibiotics along with anti-inflammatory agents & anti vitamin agents too if needed. Untill doctors opinion you can have a local application of some antibiotic ointment such as mupirocin & the smoothening agents. Consi .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 13 and i think i have a clinical/major depression disorder.I have only told one of my best friends about 3 days ago. I want help but i have some problems in my way.. i think my parents will think im lieing for attention or something.. also i would like a little more confidence in that i might have it or not.(this all started with me just feeling sad for no reason for a good amount of time, and then i took some online tests, witch all said i had depression and i read more about it. And i have almost all the symptoms.) I just would like your opinon if i should go see a doctor and if i should tell my parents. By the way no one in my close famliy has any type of depession. I would love your feelings, Thanks! ### REPLY: His admire your positive outlook and congratulate you for the attitude. Now I guess you have depression, and it could be due to some stress in your personal life. In that case, you need some help. However, let me give my opinion here. I think a combination therapy of antidepressant and low benzodiazepine would help you. These .  You can try some relaxation exercise like JPMR or deep breathing exercise. That would keep you calm and relax. For this you need experts guidance by psychiatrist or psychologist. 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 19 years old girl.My doctor has prescribed to take betacap tr 40mg once in a day for chronic headaches and high blood pressure. I am having these pills since 5 months now. I would like to ask about side effects of it and should I continue taking such a high dosage?. ### REPLY: Hi, Betacap TR (propranolol) is a non-selective beta blocker commonly used for the lowering of high blood pressure and other conditions is known to cause decreased heart rate, low blood pressure, fatigue, cold and clammy skin, difficulty in breathing, depression, sedation, and sleep problems (nightmares). If you do not have any side effects like low blood pressure the dose of Beta cap TR may be reduced by your treating doctor otherwise continue taking it as prescribed. 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: hello doctor, I am a 31 years old femail. i have a VUJ calculus of 7mm size in left kidney with moderate dilatation of ureter and pelvicaliceal system.  I was recommended flush therapy by getting admitted for a day in a hospital.  can you please tell me the actual procedure for this flush therapy? ### REPLY: Hello and welcome to . As a Urologist, let me explain this simple treatment principle. The left side kidney to bladder tube(ureter), has a 7 mm stone blocking the ureter at its lower junction with bladder, causing left sided block and pain, and thereby affecting the left kidney. Major part of urine formed is being flushed out from the right sided kidney. In flush therapy, person is asked to .  You may send the reports to me directly, for a better answer. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Over the last 2 months Ive been dizzy and had fatigue upon waking up and throughout the day. Dizzy meaning lightheaded. No spinning. My ears are also ringing. My forehead feels warm as well as each ear when I lay with my ear on the pillow. It has gone away for a week before but came back. No fever. Its the same while standing or sitting. Today it subsided but after I went out and came back and ate it came back full force. I was taking flomax for an apparent enlarged prostate as I did have frequent and short urination and burning lower abdomen. The dizziness started 2 months in taking it and I stopped it after that. Its been 2 months since I stopped. Only other thing different is Ive had a bulging vein in left forehead that causes pressure there. That is almost constant.  Occasional minor headache. Ive been to the doctor several times for EKG and even ctscan and blood tests all negative. Thanks. ### REPLY: Hi, tamsulosin has side effects concerned with the mucosa of the nose and sinuses, so can cause symptoms of the sinusitis. anyhow you have stopped.  The vein and occasional head aches will be remnant of the sinusitis. Or may not be. It may also be due to anxiety.  I to my patients with such symptoms prescribe, definite, decongestants, analgesics, and antihistamine. Gargling with Luke warm salt water can give you good relief. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my 02 yrs daughter have a cough lasting 3 weeks.she has no other symtomps as such; except a lttle cold. she is coughing generally at night  morning after awakening from sleep. our doctor has prescribed- cough syrup and cepodoximine, but no such good result. what can i do? plz help ### REPLY: Thanks for your question on . I can understand your concern. Your daughter is having chronic cough (cough for more than 15 days) and not improving with routine cough medicines. So we should definitely rule out lung infection in her case. Lung infection is common after cold in pediatric patients. So better to consult good pediatrician and get done chest x-ray to rule out lung infection. She may need higher antibiotic and other supportive .  Don't worry, she will be alright with appropriate  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 do have a question. I had a Hep c test show positive with no viral load. More test were done Albunin 5.0  alpha 1 normal alpha 2 normal Beta Globulin normal Gamma glaobulin normal. So, Is it possible for a pos. test and no viral load? Do these other normal tests prove anything as far as liver disease or support a neg viral load. OR. One has nothing to do with the other? Thanks ### REPLY: Hello. Hep c positive with no viral load means you have the hepatitis C virus, but the virus is not active now. Hepatitis C is a chronic pathology with episodes of exacerbation accompanied by increased viral load. You must be periodically reviews the gastroenterologist because your pathology is chronic but is now inactive. The other test that you say are not as important for your pathology. I wish you good health.(In case the answer would have been useful please indicate this) ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I am on pep after having protected respective anal sex with a transvestite sex worker. I have had no side effects from pep but three weeks after exposure I ve got a slight lump and a little discomfort where my left hip meets my leg. I ve also got some irritation under my right bicep. I ve felt a bit sick today but with a temperature of 37-37.2. ### REPLY: Hi! Good evening. I am  answering your query. The lump could be a lymph node swelling and along with fever it might indicate some kind of infection which might be related to the anal sex. I would suggest you to get it clinically assessed along with related investigations by your family physician/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: Need answers & advise. I think my husband might be mentally I ll & I fear for my safety Symptoms are: Extreme anger Extreme depression Constant confusion Talks to himself paranoia and anxiety Fights with someone breaking things screaming at someone he points out to me but no one is there. Constantly thinks someone following him in the car ### REPLY: Degree understand your concerns went through your details. I suggest you not to worry much. From the description you gave, if the description is correct, your husband could be suffering from Paranoid schizophrenia. Several symptoms are common for general anxiety disorder and disappointment and irritation. But paranoia and this together point towards Paranoid schizophrenia. Timely psychiatric intervention should give cure. If you require more of my help in this aspect, Please post a direct question to me in this URL. http://goo.gl/aYW2pR. Make sure that you include every minute details possible. I shall prescribe the needed psychotherapy techniques. Hope this answers your query. Available for further clarifications. Good luck. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: OK this is really pathetic but I have drug addiction issues and border line personality disorder and a light case of self harm as in the sense of sometimes I get so stressed out and angry that I will hit my head and sometimes will cut my arm, not every enough to truly hurt myseld , thats not my intent just enough to release my anger. Well a little over three weeks ago I hit my right temple and a few days later I Have a knot in the vein that runs through the temple area. The bruising has gone away and it doesnt must but the knot is there. Will this go away or have I just done some damage to the vein that Ill have to live with ### REPLY: Hello, Thanks for choosing  for posting your query. I have gone through your question in detail and I can understand what you are going through. The pain is gone away and this suggests that the inflammation after the trauma has gone down. Probably there is a thrombosed vein present which is felt like a knob. This will re-canalize with time and it won't be permanent. Most probably nothing needs to be done, and the knob will disappear with time. Some suggest application of a cream called tomophobe, but mostly it will not be required. Hope I am able to answer your concerns. If you have any further query, I would be glad to help you. In future if you wish to contact me directly, you can use the below-mentioned link:bit.ly/ .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: About a month ago I developed a small rash in the antecubital region of my left arm. I applied some Aquaphor for a few days and it went away. Well, yesterday it reappeared. I have kept Nystatin on it and it seems to be going away. It is only slightly itchy but the first day was really red. What is this? ### REPLY: Hi! Thank you for your question! As you mention statin, that is an antifungal agent, and your rash seems to disappear it could also be a dermatophytes (fungal infection). I would recommend you continue with Statin twice a day for at least 2 weeks, and also a week after the lesion disappears. It could also be a dermatitis, and that's why it went away with Aquifer. Sometimes these two conditions can present together, that's why I also recommend you use a topical OTC corticosteroid once a day for 1-2 weeks. You can also mix the two medications together. You can continue with Aquifer, several times a day to HY . I hope you get better. Please feel free to contact me again if anything is unclear. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 think I have a psoriasis at my labia majora. It s very itchy and burns in pain when scratching. How can I treat this? Is there any drug you can advice me? ### REPLY: I had a very similar sounding lesion. It started on the outside of the labia major and slowly spread toward my leg and toward the inner part of the labia major. It was shingles. The itching passed after a couple of weeks, but the pain was there for months afterward. Two years later I still have times when the area of origin is painful, though no lesions show up. By the way, my father had psoriasis. It itched badly, but was only slightly painful when he broke the skin scratching. On the other had, the pain of shingles can be quite acute. Mine certainly was. Mary ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 three year old is complaining of headache in the front and back of head, his neck hurts and his ear hurts just behind the ear. He is running a slight fever and his face is flushed. Should I be concerned and have him checked at the clinic for menigitis? ### REPLY: Dear friend, after thoughtfully reading the case history of your child I would say he is suffering from some infection which is causing him pain in head and neck region. Neck pain in this age group always points to the meningitis. So I would say give the baby some antipyretic for his fever. And then go for a thorough check-up and blood investigation for meningitis under a bedside guidance of any paediatrician.my best wishes for your little one. 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 have a smooth squishie lump/bump on top of my scalp. Its white save for some red spots ringing the outside.feels like there is fluid inside, and the "raised" area is hairless. The area itself was swollen and tender due to folliculitis. Took antibiotics to treat the folliculitus that cropped up as well as Clindamycin to treat the "scalp pimples" after while the infected area became smooth and soft and devoid of hair and squishie. ### REPLY: Hi. Thanks for your query. Note the history of Squishy lump on scalp, feeling of fluid inside, hairless at the top, swelling and tenderness must have come in the later stages. All this is characteristic of an infected sebaceous cyst with folliculitis may be as a secondary effect of infection. I would advise you the following:Consult a General Surgeon, Get a course of an antibiotic and an anti-inflammatory medicine. Surgery at an appropriate time will solve your problem. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi im male name is masroor. i am 42 years old from pakistan , i have stone in my kidny its size is 0.5 . before few days i had kidny pain and my urine is blocked i took treatment then my another stone its size 1cm(like as date seed)is reduced through urine pressure . but 0.5 stone still there, my doctor take me tablete UROCIT for three month twice a day  for that dissolve this stone 0.5. now my problem is that my blood examination test show the high level of alkline phosphates about 777 u/l. and uric acid is about 3.4 mg/dl. now please suggest me what i do? ### REPLY: HelloThanks for query. Based on the facts that you have posted it seems that you had two stones in kidney of the size of 1 cm and another of a size of 5 mm. The stone of a size of 1 cm has passed out through urine .and other stone of a size of 5 mm is still there in your kidney. Normally stone below the size of 8 mm pass out through urine spontaneously and does not require any active intervention. Following measures will help your stone to pass out .1) . 2) Take Tab Tamsulosin once daily.3) Take a prophylactic antibiotic like Norfloxacin twice daily for 10 days .4) Repeat your Scanning after one month. Hope this will work for you to pass the stone out. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I just finished a 5 day bout with diarrhea . Ran blood tests, took stool sample. Everything came back normal or negative. Now, one day later, I am having severe pain in my left abdomen. When I saw a Dr. last Friday, she asked if I had pain in lower left abdomen .. At that time, I did not. What might she have been looking for? I m due to leave on a 9 hour road trip tomorrow and am concerned about what might be developing. Any ideas? ### REPLY: Hello, Thanks for the query to . Forum. I would come up with these possibilities for such type of pain in abdomen, This includes.1 Renal stone, diagnosis can be confirmed by ultrasound both kidneys (including ultrasound of ureter, urinary bladder).2 Hyper acidity (gastritis) , diagnosis can be confirmed upper G I endoscopy. Usually after diarrhea patient develops gastritis. Physical as clinical history is also important in such type of cases.3 Amoebic colitis, diagnosis can be confirmed by physical examination as colon found palpable. In my opinion consult a physician and get his opinion about left renal colic. 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: My friend just had a carcinoma which was wrapped around his spinal cord in the lumbar region removed one week ago. He was referred to a Rehab hospital this morning. Justa few minutes a go the attending physician informed his wife that he is going to transferred back to the University of Chicago immediately due to a low RBC. What wwould be the reasons this might happen other than an internal bleed? ### REPLY: Hello and welcome to , Low red blood cell count (RBC) is caused due to decreased production of RBC's, increased destruction of RBC's or loss of RBC's. The loss of RBC's could be internal or external. You need to consult a hematologist for certain investigations and thus management. Complete hologram with peripheral blood film examination are required. RBC indices- MTV, MCH and MCHC should be done to assess the status of RBC's. These investigations will determine the presence of anemia, and its cause. Management can be instituted when results of the investigations are obtained. Thanks and take care .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: last night i had a terrible headache with lots of pressure in my head. i also had nausea, palpitations, confusion and weakness. i almost felt like i was out of my body watching what i was doing. i had chills for several hours and then suddenly i was incredibly hot and clammy. tonight i still feel a little lightheaded and my hands are kind of weak feeling. ### REPLY: DearWelcome to ChatDoctorWe understand your concerns went through your details. From the look and feel of the symptoms, it seems that, last night you had nocturnal panic attack. The cause most probably could be your stress. Try to recollect, were you stressed in the near past or are you doing something (job or burden) which continuously stresses you? Also recollect whether you had any abdominal or digestion problems or disorders on these days. It is quite natural, after panic attack, the symptoms do wander around. In any case, you should consult a physician for an investigation and further advise. If you still need my assistance in this regard, please use this link. http://goo.gl/aYW2pR. Please remember to describe the whole problem with full detail. Hope this answers your query. Please feel free to post follow-up queries. Available for further clarifications. Good luck. 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: On top of my buttocks crack I felt a small ball like lump which hurts when touched. There are no visual sign when looking at the area. It is actually under the skin. The skin is clear.The pain and lump does come and go.I play a lot of sport, but also sit down in the same position for a long period while Im at work.What is the inner lump and why does it occur? ### REPLY: Hi, Thanks for writing in. A lump in that area can be due to an infection below the skin or a benign tumor. It is best to consult a surgeon and confirm the plane of swelling. If felt necessary an ultrasound scan of the lump may be done, and it will give a confirmation on the location and features of the lump. Infective lumps usually respond to antibiotics and anti-inflammatory medications. Such infections may occur due to sweat in the region infecting the hair follicles in most people. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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.since i got removed my upper tooth gum is healing good but now i notice that gum where is hole feels big and like flabby.i was thinking maybe i irritated it because i keep touching that area with my tongue.so feels like piece of extra gum is hanging.is that normal ? ### REPLY: Thanks for sharing your concern with Heath Care Magic.! Please note that, post extraction your dentist would have informed you not to disturb that area as this will impede the healing process. However, you have been disturbing this frequently the healing of the socket would have been delayed. The flabby tissue usually gets remodeled within 2-3 weeks post extraction, if still persist you can revisit your dentist for excision of the flabby tissue. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 Nisha.I am 25 years old.  Before  2 years my menstrual cycle is irregular, after some tests my dc told me that Im suffering from PCOS, at that time she prescribed me Crisanta. After taking a course of 9 mnths my menstrual cycle gets normal. But now i want to conceive, but I am nt getting it. Last week I had my ultrasund of abdomen and doc told me that I had cysts in my ovary and again she prescribed me crisanta for 2 months. Now suggest me What should I do.??? ### REPLY: Hello, Once you have achieved regularity of your menstrual cycles, now the next goal is to make you ovulate because without ovulation, pregnancy is not possible. To achieve ovulation, following methods AR employed......taking medicines like CLOSED ...reduction of weight helps in induction of ovulation. Even a 10% reduction in weight can induce ovulation in a PCs patient..... Use of medicine like METFORMIN, which helps in reduction of insulin resistance and helping in ovulation. You must consult a fertility expert and get managed and treated properly. Thanks ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I keep having these weird jittery laughs in my chest. Its been happening for years. and sometimes when it happens it feels like I have to force myself to breathe. Im wondering if its an anxiety symptom but  sometimes it happens and im not even anxious. ### REPLY: Thanks for your question on . I can understand your concern. In my opinion, you are mostly having stress and anxiety related symptoms. But better to rule heart disease like arrhythmia because this can also cause similar symptoms. So first get done ECG, 2d echo and Holder monitoring (24 hour continuous monitoring of ECG). If all these are normal then no need to worry about heart diseases. Your symptoms are mostly due to anxiety and stress. So better to consult psychiatrist and get done counselling sessions. Try to identify stressor in your life and start working on its solution. You may need anxiolytic .  Don't worry, you will be alright. First rule out arrhythmia. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: I noticed that my urine was pinkish in color and upon checking the doctor confirm there is blood in my urine.The doctor prescribe C-.Flox (antibiotics),Avosoda(Urinary Alkalinizer) and Potassium Nitrate .Jfyi,I had kidney stone 14 yrs ago  and can it reoccur? I went for my urine test today and attached is the result for your kind advice.Your kind advice will be highly appreciated --------------------------------------------------------------------------------URINE FEMEAPPEARANCE -HAZYCOLOR -STRAWSP. GRAVITY 1.010 1.005-1.030pH -8.5 (H ) 4.8-8.4PROTEIN -NILGLUCOSE -NILKETONE- NILBLOOD- 3+MICROSCOPICWBC -NILRBC -20-50EPITH -OCCCRYSTALS - & CASTS- NIL** ### REPLY: Hi! Welcome to ! I understand your problem, nothing to worry it will be resolved in a matter of time. As per the problems discussed in your question, red colored urine with the evidence of blood 3+ and 20-50 RBC's will NIL WBC are highly suggestive of stones in the kidney or urinary bladder. To confirm the stones in your urinary tract, get the ultrasound scan done and consult your GP. I hope I have explained the problems listed in your question.Regards! ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: My sister told me that I have a rash on my neck, but I brushed her off because I didn t feel anything. An hour later, I checked in the mirror once it began to itch, and I realized that my collar bone area has a large rash and bumps (and my neck is feeling weird). I just took some Reactin, because I think it was due to allergies, but I m not sure what to do. ### REPLY: Hi, It seems that you may be having contact allergic dermatitis on neck. There may be some cause. Dust, housedust mite, clothes,soap, water,cosmetics, deodarant, pollen.etc. may be responsible. You consult dermatologist for firm diagnosis. Antihistamines like levocetirizine may be taken. If needed, steroids in tampering dose may be taken. Apply mild steroid cream. Avoid contact with suspected allergens. You may be benefitted. I hope you got my answer. Thanks. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: i had conceived 10 yrs back premarriage and had got it aborted,2 yrs back i got married and trying hard to conceive but no resultswe have been to fertility center after all test they told us i done have right tube and my husbands motilty is low.pls let me know will i conceive ### REPLY: Hi welcome to . I have gone through your question. Your right tube blocked!? Of one of the two tubes is patent then you can conceive from that side. I would advise doing follicular scan to make confirm follicles are developing. For low sperms' motility I would advise doing color Doppler ultrasound to rule out varicocele, and to see vascularity of testes. And consult urologist for the same. Hope I answered your question. Would be happy to help 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: im a smoker and when i breath it hurts in my back and my chest feels so heavy ofcourse i have had nasal drip and very very thinck phlem for the last yr and have been takeing mucinex for 6 months now ,and im so worried i also have been haveing trouble with food getting stuck in my throat latley and they did the test on me last week   for the barrium swallow  and if there was something like fluid on my lungs could they have seen it with that test ??? ### REPLY: HelloWelcome to , Your history and symptoms are suggestive of respiratory infections which should be evaluated properly to provide adequate treatment. You may require physical examination and LSB investigations like CBC, chest X-ray and urine examinations to make a proper diagnosis. For the present symptoms I would suggest you to follow1. Steam inhalation with Vocals.2. Oral antihistamines3. Oral antibiotics like Tab Autoclave, 625 mg, twice daily.4. Spy Ambrosia S. Thank you. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi i have asthma and have been on Advair for years about a month ago I ran out and instead of refilling it I thought I would try to deal with out it! On Friday I could not take it anymore and had to get it filled began taking it right away. now I have this heavy filling in my lungs and it still is a little tough to breathe, why and what could be causing this because the whole time I have been on advair I havent felt like this at all??? ### REPLY: The steroid and bronchodilator combo in Adverse has made you dependent on it, and you could not afford to live without it for a day even. To my own patients I would suggest taking steam inhalation by putting Eucalyptus leaves in water when boiling. If leaves are not available, Eucalyptus oil or Picks vapor (also contains Eucalyptus oil) may be added. Tulsi (Holy basil) leaves, ginger pieces may be boiled in a glass, allow becoming lukewarm, add little honey and little turmeric powder to it. Sip it daily once at least - empty stomach. Make it a habit. May continue long. If any irritation occurs, ginger may be discontinued intermittently. After about four weeks you will find if you miss Adverse, you will have enough immunity not to feel discomfort. Further, slowly you will not feel frequent need of Adverse in the future. Hope it 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 working as Mechanical design engineer at bangalore for 5 months. I am 32 male , height 158 cm, married and having a kid. working before in ernakulam.good company , only salary was low. But the present company is small , and i am being cornered. I am feeling heavy tension, not able to take food, and would like to come baack home . i am taking sertraline based on my doctor uncle who is psychiatrist in london. i cannot continue in present company. if pressurized by my parents and family, i will try suiciding. I was treated before  thrice for severe anxiety and tension .pls give me a solution ### REPLY: Hi dear,first why you are not adjusted in company ?it is salary issue or other issue?and you have such feelings only at your work place or at home also?sometimes due to adjust at your work place also cause such problem. Sertraline is a good molecule to overcome depression and anxiety so took it in an adequate dose. As you are having past history of similar complain so take medication regularly and also go for counselling. Consult psychiatrist face to face. 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: Twice in six months, on two separate occasions, I had been awakened out of my sleep with sharp, shooting pains on the bottoms, sides and top of my feet. After stomping, scratching, rubbing and hitting them against the wall or door frame the pain finally died down. Last week right after Christmas, after several months without incident, the pain happened again. This time, the pain didn t die down, but became more intense. So much so, that I had to go to the emergency room. They took blood and urine and ruled out diabetic nerve pain. They said foot pain could be any number of things. They gave me two shots, a prescription for Ketorolac and told me to follow up with my doctor. The earliest I can get in to see my doctor is January 8. Other than what is this unbearable pain, what other questions should I ask my doctor and what tests should be done? Thank you PK ### REPLY: Hi Dear, Welcome to . Understanding your concern. As per your query you have sudden and sharp pain in feet. Well there can be many reasons for symptoms you mention in query like peripheral neuropathy, injury, gout, corns and callus, soft tissue injury or venous insufficiency. For now keep your legs in hot water tub with Epsom salt for 15 minutes daily and take proper rest. Doctor may recommend orthotic devices like special shoe. You should reduce your weight. Also do gentle message with almond oil and take ibuprofen or acetaminophen for pain. I would suggest you to consult podiatrist for proper examination. Doctor may order CT scan or x-ray along with blood test and urine test and physical examination to confirm the diagnosis. Doctor may also refer you to orthopedic surgeon for foot problem, who may prescribe diuretic along with muscle relaxant, anti-inflammatory. Doctor may also recommend surgery in case of any abnormality. Hope your concern has been resolved. Get Well Soon. Best Wishes, ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi, I stay in Gurgaon, India for last four years. Last three years i have had typhoid every year in summers. Even this year what started as a normal sunstroke fever later was diagnosed as typhoid. This too when i have taken booster dose just two months back. ### REPLY: Hello Typhoid fever is a systemic water born disease characterized by fever 7 abdominal pain and by dissemination of Salmonella type or paratyphoid, for which humans are the only hosts. As you mentioned that you have fever in every summer (so this may be due to infected water). Take care about that (water boiled, cooled or sterile water to be used). Vaccinations are available as:Typhoid ty21, oral live attenuated 1 capsule every other day for 4 doses. Booster dose after 5 years. Typhoid Vi capsular polysaccharide, injectable (typhoid) 1 dose INTRAMUSCULAR. Booster dose after every 2 years. So this is a complete vaccination chart. The . In few cases ceftriaxone 2 gm for 7 days. Since all these are prescription  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 knuckle which is red, sore and has now has a large, solid lump on it. This can be seen only when I have my hand felt. It cannot be seen when my hand is in a fist. I t hurts as I start to make a fist, and I feel I have less strength in my hand. Please can you help? ### REPLY: Hi! Thanks for sharing your recent health problem with us! As per your description, the lump in your hand is solid, large, painful, inflamed and possibly within a tendon or joint that's why it is not felt or visible when you make a fist. Therefore, I would like to consider nothing but an infective pathology in your case! I think there is nothing to worry about this, but you definitely need surgical attention as it could be kind of ganglion, bursa, inclusion cyst, parasitic cyst, tumors or even tuberculosis also! Therefore, you must see a surgeon for a clinical examination, few tests if necessary, rest of the joint and some medicines or surgery if needed!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 14 year old son started having severe pain in his teeth when we started descending on the airplane this afternoon. He spit out a small amount of mucus and felt a litter better. He had taken a Zyrtec prior to traveling. The pain calmed down for about an hour or 2 but is now hurting him again.  Had teeth checked and X-rays  a month or 2 back so I doubt it is a cavity. ### REPLY: Hello thanks for consulting at .it could Barodontalgia, commonly known as tooth squeeze (aerodontalgia), is a pain in tooth caused by a change in atmospheric pressure. The pain usually ceases at ground level. The most common victims are SCUBA divers because in deep dives pressures can increase by several atmospheres and military pilots because of rapid changes. Barodontalgia is a symptom of dental disease, Indeed, most of the common oral pathologies have been reported as possible sources: dental caries, defective tooth restoration, pulpits, pulp necrosis, apical periodontitis, periodontal pockets, impacted teeth, and mucous retention cysts. Hence please consult a dentist since it could be teeth problem.hope it helps, tc ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: hi am vila 23 years old am suffering from raw rice addition since am fifteen. I do 2 mouth surgery beacause of broken teeth all my teeth are dead. i have belly pain.. difcficulty to sit,to walk.. feel out of breath sometime. The thing is that iwant to stop. I ve try lots of time but i can . I have difficle menstruation. I eat raw rice all dat long if i dont eat i can t sleep i even have get insomnia problems. the think is that i want to stop but how ? ### REPLY: Hi Vila, Thanks for trusting  with your query. Your problem seems to be a very rare kind of addiction.  Based on the information provided, it seems you are motivated to give up this addiction as you appear to understand the fact that it is hurting your body physically. It seems that you are struggling psychologically as well. I guess first and foremost, you should get yourself checked physically as raw rice can cause some physical issues and some problems of menstruation could be due to other unrelated/related issues. An opinion from physician or gynecologist might be helpful. Next comes the issue of addiction. I suppose one method could be to use Exposure and response prevention strategy. The basic principle would be to expose you to raw rice which will possibly induce the desire to eat it and then have someone stop you from eating it. During this process, you might experience significant restlessness and anxiety. If you are motivated enough and know relaxation techniques, try to be in this situation for approximately 90 minutes or when you feel your anxiety is wearing off without any additional help. You will realize that gradually the intensity of your craving is reducing and after sometimes start doing it yourself. You can take the help of a clinical psychologist in this process. The role of medication would be very limited. However, I believe consulting a psychiatrist to explore other psychological issues (if any) can be of further benefit. Hope this will be of some help. Best wishes,  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: my father got unwell a week before.Doctors are not advising anything and are wiating for the bone marrow test report.his haemoglobin is falling from 8.1 to 7.5. Now it 7.1 . his platel;ets have flucTUATED FROM 5,000 TO 27,000 TO 18,000 TO 45,000 TO 51,000. iT HAS NOW AGAIN DROPPED BACK TO 41,OOO . dOCTOR SAY THERE might be an infection in the blood . My dad is slightly diabetic kindly sugest au prognosis ### REPLY: Hello, Firstly, the low level of platelet is known as thrombocytopenia.  Thrombocytopenia, may occur due to many causes like Idiopathic thrombocytopenia, Some infectious conditions, some leukemia.  Anemia may also be present in these conditions.  To differentiate these conditions, White blood cells are most important. What was Total count? What about the hematocrit values? If normocytic normochromic anemia occurs with an increased WBC and decreased platelets, then bone marrow is important for excluding leukemia.  So, wait for the bone marrow report.  Only then any conclusive diagnosis can be given. ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi doctor, my 20-month-old son is having cold and fever on and off for the last 2 months. Before this, he only had a fever and cold when he was 12 months old that got well in 2 days with the paracetamol. He had almost 3 fevers in the last 2 months. For the last fever and cold 2 weeks ago, he had Erythromycin Ethylsuccinate, ibuprofen, and some cough syrup. He has been having runny nose continuously for the last 2 months. I have tried Prospan for his cough last month. Again, yesterday, he started having cough, fever, and vomiting. I gave him some paracetamol and he slept well, got up normally and had his dinner and played well, but again yesterday night got fever. Is anything serious??? What is he having???? Is azithromycin helpful?? ### REPLY: Hi... Thank you for consulting in  .THIS LOOKS LIKE RECURRENT VIRAL ILLNESS AND ANTIBIOTICS ARE NOT REQUIRED AT ALL. Cough and cold are viral 95% of the times in child .  For cold, you can use anti-allergics like cetirizine and for nose block, saline nasal decongestants will do. Paracetamol can be given in the dose of 15 mg/kg/dose (max ceiling dose 500 mg) every 4-6th hourly, that too only if fever is more than 100F. I suggest not using combination medicines for fever, especially with Paracetamol. For cold, you can use Cetirizine at 0.25 mg/kg/dose every 12 hourly for 3 days. For nasal block, plain saline nasal  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, 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 irregular cycles 21-25 days . I have been ttc for 6 months. I think I ovulated on CD12 (had follicle tracking) So my period is due today or tomorrow. Really feels like it is due , have cramps and pressure in my abdomen. No bleeding yet but after a bm this morning did have a creamy pink discharge . My question is really how long after spotting / CM like that would should bleeding start? Also if there is no further bleeding, could I be pregnant even though I feel like Im having the ususal pre-menstrual cramps? ### REPLY: Hello dear, I understand your concern. In my opinion the period might start spontaneously or within 1-2 days after spotting, but it might be variable. As the ovulation had occurred on 12th day the period might come on 26th day in case if there is no pregnancy. The presence or absence of pregnancy cannot be definitely predicted just basing on symptoms like cramps, spotting etc. I suggest you to do a urine pregnancy test a week after missed period for confirmation. Usually a urine pregnancy test done after a week of missed period gives accurate results. So relax and avoid stress. Nothing to worry. Hope this helps. Best regards..... .  ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I m fourteen years old and there s a rough patch of black skin on my hand . It s been there for a few weeks and I figured it would go away by putting sunscreen on it. (I ve had dry, hyperpigmentation on my face before and it went away with sunscreen.) However, it s been a few weeks, and it hasn t improved and it s spread from my hand to now a little bit of my wrist .__. ### REPLY: Hi thanks for posting There is a rough patch of black skin on your hand since a few weeks. It could be post inflammatory hyperpigmentation, only sunscreen won't help. You can use the following pigmentation creams like HY . Sunscreen may be used during the day steroid cream like comatose or fluticasone twice a day. Spot TCA peel or glycol peel may be helpful since it is spreading, I advise you to contact a dermatologist hope this helps you ### END


Below is an instruction that describes a task, paired with a human input that provides further context. The task is to simulate a doctor-patient consultation. The human input will be a description of symptoms or health concerns from the patient's perspective. Write a response (reply) that appropriately completes the request, providing an accurate, thoughtful, and empathetic response that a real doctor might give based on the information provided. Never use the words 'Chat Doctor' in your response ### HUMAN: Hi, I am 31 male. My last ECG indicated RBBB incomplete and right axis deviation. Also, in the last half a year I had a feeling of heavy head/eyes and fairly high blood pressure (140/90 on average). I tend to play lots of sports, but still smoke (although down to 3 cigarettes/day). Could high blood pressure be the cause of the ECG readings? ### REPLY: No, high blood pressure will not result into incomplete RBBB. Incomplete BBB Is a physiological variant, and by all means it can be present in normal individuals, so don't be worried about the same. Right bundle branch block (BBB)as the name suggest corresponds to the right side of the heart, Why I all telling you this ? Right side of heart pumps impure blood to lungs for oxygenation, so any problem in the lungs because of your smoking can cause a problem to the right heart in very long run, hence better to quit it when you are young. Smoking can result in higher blood pressure as nicotine is a stimulant. Hoping I could help. Regards .  ### END