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ophycare

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icliniq-dataset

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Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had mumps five months ago and after that i started to have an infection in my left testes it was swollen and now it has shrunk to almost half the size of the other one as i am sexually active i feel a pain in each of the vas deferens after sex if i do not have sex for days they become sensitive i was treated with ceftum mg the first time i had an infection now my question is is there any chance that the infection is still in my body and do i need to get examined for it for the time being please suggest some precautionary antibiotics for my relief ### Response: i can understand your concern you had mumps and this is a viral infection known to cause an inflammation of the testis in some cases take care for more information consult a sexologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am currently on the yaz contraceptive pill i skipped my sugar pills for around four months and had a breakthrough period this month i had my period last week but i still have some residual brown discharge for about a week now additionally i had sex a few days ago and bled during it nothing hurts or is sore i just want to know how long i am going to have the brown discharge and if i should be worried or if i should do anything about it ### Response: hello the brown discharge should be temporary i would recommend you have a period for the next couple of months and not skip the placebo pills temporarily to get back on track if you have not missed any pills pregnancy is very unlikely but i would recommend a pregnancy test for added reassurance if you have not had a recent test for stds like gonorrhea or chlamydia i would also get tested for those as these infections may have no symptoms and can cause spotting or bleeding after intercourse if the problem continues and no other cause can be found you can consider changing to a different pill take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my son aged years has got his left eye and right with i am now very worried what good precautions should i take with him can you suggest me what should i do ### Response: i have gone through what you have mentioned and understand your anxiety about your sons eyesight and are high myopic powers and the chances are that the power may progress as your son is still young my advice to you is avoid reading or holding objects very near to the eye this will cause myopia to progress faster and will worsen the condition every six monthly visits or follow up visits as per doctors advise since the myopia is of a high degree there will be excessive stretching and degeneration of the structures of the eyeball this can cause problems such as retinal detachment regular followups help us in picking up changes faster and in preventing such complications as retinal detachment ask your son to regularly selfcheck his vision this is done by closing each eye one at a time and observing how a particular object or letter looks urgently visit your doctor in case of a sudden

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i just got one side of my wisdom teeth removed both upper and lower six days ago and i have another one scheduled after two days for the left side the upper is fine which they pulled the lower they pulled the tooth without removing the root because it was too close to the nerve i do have some stitching in this area currently on the lower cheek noticed a hard lump about inch between my lower jawline and cheek area is this normal because of swelling or something else currently taking amoxicillin mg and ibuprofen mg please let me know what this hard lump is also generally on the lower side where this lump is remains sore ### Response: hello the lump is mostly a hard swelling which forms postsurgical removal of the wisdom tooth or maybe even by swollen lymph nodes due to infection it takes a week or two for the swelling to subside sometimes if the root is still inside the infection may be remaining there causing swelling get an xray done to find out the exact problem and stronger antibiotics like augmentin amoxicillin and clavulanic acid along with a painkiller for a week for more information consult a dentist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had deep unprotected sex for three minutes with a broken condom with a sex worker who looks younger and healthy and aged between it was my first intercourse with a sex worker and i am worrying about expose to hiv i have started fearing from the minute where i had broken condom intercourse and she said to me that she does not have hiv and they never allow anyone to have sex without a condom because of fear of getting infected so there is no need to worry but i can not believe her and started studying about hiv and its symptoms and i have a feeling of infection because i got red dots in my finger pits and cold and throat infectioni want to know what are the red dots on my finger which i got i got it tested many times in those three months and got a negative result i am worrying abt six months test ### Response: hi firstly i want to tell you that the tests which are done these days are highly sensitive and specific and give accurate results congratulations on your three months hiv test postexposure being negative numerous studies have shown that of people will have enough antibodies to accurately test positive at three months in some of the cases it takes as long as six months to test positive but this is rare since everyones window period is different and as per the recommendations and i also suggest to get retested at six months red dots on finger pits cold and throat infection can occur in various conditions not necessarily hiv relax move forward just go for a repeat hiv antibody test at six months take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i need advice after my second ct chest result six months back i went for a ct scan because i have got chest pain which suddenly comes and goes and i wanted to go for a checkup the ct showed a rightsided nodule measuring mm and was advised to rpt interval scan in six months i have done the second ct the previous nodule is still there and they found another onein the lll a mm nodule is representative of an intrapulmonary lymph node no suspicious lung lesion tiny mm rll nodule noted no enlarged lymph nodes mild thymic hyperplasia the partly visualized upper abdominal viscera appear unremarkable no aggressive bony lesion they said i do not need to do anything which is strange because there are two nodes now and the second one was not there six months ago do i need some kind of medicine therapy to clear my lung from this node or do i need to check if it is growing or not after one year ### Response: hi according to guidelines when there is a single nodule in the lung of size less than mm we ask to follow up in six months for repeat ct in the repeat ct if we find any enlargement of the nodule or any new developments we usually ask for a biopsy of the existing nodule that is how we practice so i think you should repeat your ct after six months and if the size increases you should get a biopsy done

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had sex for the first time after that i did not get my periods yet i went to a gynecologist she had taken my blood sample and it was negative but still i have not gotten my periods and it has been a week ahead what could be the reason for my late periods ### Response: hello as the serum beta hcg levels are less than miuml the pregnancy is definitely ruled out the delay in the menses is mostly due to sex induced stress after the first time when reproductive hormones readjust themselves the menses can get delayed even up to two weeks so just wait for another week and they should arrive

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my friend aged had two drops of phenol mistaking for milk he vomited and had lot of salt water please advice for any side effect ### Response: hi i want to assure you not to worry as everything is going to be fine if proper care and treatment is opted in for i have thoroughly gone through your case and can well understand your genuine health concerns no there is not much problem right now as he vomited and also had a lot of water we usually do not go for emesis vomiting for phenol poisoning cases because it is a volatile compound and causes vapors entering the lungs through the as it was only two take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: some mornings during the week i get a quick flash of numbness over my left temple it is never at night or during the day it can happen more than once sometimes if i move roll over or get up i can make it stop it does not hurt and is very fast what does this sound like ### Response: hello i understand your concern and would explain that your symptoms are not typical of any neurological disorders the emotional stress may trigger this numbness as it could be related to a muscle spasm in this region waking up is a kind of stress for the body as we pass from total rest during sleep to an active morning anyway i do not think that you need to perform any tests as it does not indicate anything serious so just relax and try not to think about it for more information consult a neurologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my last usg report showed intrauterine pregnancy with mm gestation sac no fetal and yolk sac last week i had brown discharge with mild lower abdominal pain and was prescribed susten mg oral now i am feeling the pain frequently in the right lower abdomen with mild bleeding and pain it is less when i lie on bed what to do ### Response: i have read through your question and understand your concerns i think it is threatened abortion you should take bed rest along with tablet susten mg twice daily progesterone for two weeks and mbryosafe sachet once daily larginine i think it will help you and give you better prognosis ultrasound is required after two weeks for evaluation

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am i have had glandular fever shingles influenza and have an autoimmune condition hashimoto s disease i believe i may be more vulnerable than the average person my age to get coronavirus due to my weakened immune system should i be self isolating i am ok to do so ### Response: hello thank you for reaching out i understand bases on the available data those who are above and with medical condition such as hypertension cardiovascular disease and diabetes are the most vulnerable population thyroid disease and any other autommine condition is not known to be associated with increased risk of viral infections in general nor is there an association between these disease and severity of the viral infection however if you mild symptoms of cough and fever i would still recommend that you do self quarantine and monitoring i would still recommend that you wash your hands regularly with alcohol soap and water and practice social distancing i hope i wa able to answer your concern is there anything else i can help you with

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female who has had an elevated ferritin level for many years now my last ferritin level was days back my ferritin level has been as high as my tibc uibc iron and iron saturation have always been within normal range my glucose has always ranged from to i was tested for hemochromatosis and results are negative my doctors keep telling me that we will just watch my ferritin level and i have bloodwork done every six months i was diagnosed with fibromyalgia last year i am looking for some answers and some help ### Response: hello elevated ferritin could be from congenital hemochromatosis but hfe gene mutation is negative so it is excluded attachment removed to protect patient identity if you are having repeated blood transfusion history then provide history regarding that i suggest you investigate with transferrin saturation as well next time when you investigate for ferritin do not worry about high serum ferritin as all other related parameters are also within range if ferritin constantly remains elevated than phlebotomy can be done to decrease the ferritin level once transferrin saturation investigation has been done provide history regarding that take care for more information consult a hematologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have had a fishy odor down there since i was in elementary school i was not sexually active at all either just a couple years ago i realized i might have something called bacterial vaginosis i went to the doctor for it a couple years ago and got prescribed metronidazole and it did nothing for me ever since then i have not really gone to the doctor about it again i am worried because i have read that bv left untreated can make you infertile how common is it that this could happen and do you have any tips for me ### Response: hello yes you have heard right that if vaginal infections are left untreated they may lead to pid and infertility it is a serious issue which must be dealt with promptly and appropriately bacterial vaginosis leads to change in vaginal flora and ph which results in fishy odor and discharge metronidazole is the recommended treatment for it but as you say it has not affected you then i would suggest that you must not neglect it and get yourself fully checked by having vaginal swabs tested and getting exact diagnosis and treatment secondly hygiene is of very much importance with regards to vaginal discharge some tips are as below keep the vaginal area clean and wash with plain water as much as possible avoid any cosmetic products over the vaginal area and wear cotton rich undergarments

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my body is getting severe itching after taking a bath or while sweating initially it used to happen only in winter to years back and then gradually started in rainy days also now in summer also while sweating it is so irritating like that i am going to be mad i have stopped using soap and also took clonafit mg and betonix prescribed by a dermatologist but there is no improvement please help me out of this ### Response: it looks like you are suffering from aquagenic pruritus take the tablet i am prescribing and show me again after days get the investigation mentioned below done aquagenic pruritus cbc aquagenic pruritus aquagenic pruritus tablet teczinem monteleukast and levocetirizine mg bd for days

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a male i do not have any medical history been always healthy for the past months i have been experiencing this facial tightness which comes pretty often throughout the day with different intensity the facial tension usually comes half an hour after i leave the bed the tightness on my face happens to be on both sides of my face but usually more intense on the right at times i can feel it from my neck all the way up to my face as of recent i have been feeling this slight burning sensation on my chest to my shoulders as well prior to this facial tightness i have been suffering from this burning feeling on the centre of my chest for about a month it was my first time experiencing heartburn and i thought it was heart related went for xrays and echo heart ultrasound everything came out fine i have a healthy heart what made the burning chest sensation go away temporarily is lying down eating exercising and drinking alcohol and the weird part is the same thing helps me relieve my facial tightness temporarily is the same thing as that for the burning chest sensation lying down eating exercising and drinking alcoholsince having this facial tightness i have paid numerous visits to different doctors even the neurospecialist and they all said it was anxiety the doctors did facial senses test where they take a piece of fine cotton to touch different parts of my face i had to close my eyes and tell them where the spot is i have no troubles at all i did blood test it came out normal they told me i do not need to do any scans and that it was merely anxiety and it will go off by itself i convinced myself that i had anxiety because of the one month heartburn ordeal that i was suffering from even though the facial tightness was there i tried my utmost best to ignore it i do not think that i have any anxiety in me now as i try not to think of the weird tightness sensation however it has been whole months and now i am getting alarmed and worried that it is still here and with newer sensations as i described above in all honesty i do feel that the intensity of the facial tension as compared to i first experienced it is less however it is always there even as when i am typing this i do not see any physical change on my body not sure if it is neuro damage i am worried sickhope i can get some form of advice and diagnosis ### Response: hello i read carefully your question and would agree with your doctor on the fact that all your symptoms are suggestive of anxiety the fact that your symptoms are relieved by lying down alcohol or physical activity is another argument in favour of anxiety anyways before coming to this conclusion i would recommend checking vitamin d plasma levels for possible deficiency and blood pressure for possible imbalances it is also necessary performing a cervical spine xray study in order to exclude any possible bulging disc in the cervical vertebral column which could lead to burning sensation in the neck and shoulders in the meantime i would recommend taking magnesium supplements to help relieve the muscle spasm

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother is years old she had been treated for tb tuberculosis of the abdomen as her ultrasound of abdomen finding was thicken bowel loop in general terms it was informed about tb in her abdomen accordingly medicines were given to her as per the advise of a local md doctor treatment continued for three months and due to some discontinuation of medicine it relapsed and again she was diagnosed with thicken bowel loop as per usg again treatment continuedhowever while undergoing treatment she lost sensation in her legs and complained of losing sensation in her legs and numbness in her feet and was unable to put on slippers in her feet with difficulty in moving she also complained that while moving she felt as if she was moving on a bed of soft cottonsubsequent treatment by neuro experts revealed that overdose of treatment of her tb in abdomen resulted in this condition and she was diagnosed for peripheral neuropathy and was advised for biopsy for proper diagnosis meanwhile she fell and hurt herself which was later on diagnosed that her spine at was compressed due to felling abruptly and accordingly she was advised to take bed rest for three months slowly she recovered from this condition felt pain in her back and was facing another kind of problem as she could not sit for a longer time and preferred to lay down on the bedfinding her bad condition subsequetly we also took consultation from other neuro experts at a prestigious institution where she was prescribed lupivitin one tablet and sammy one tabletwhen condition persisted thereafter she was given primosa one tablet daily neurox one tablet daily maxglobin mg one tablet and defart mgbut whenever she was given medicine her condition further aggravated after about six months of treatment by the neuro expert she has now been referred to the department of immunology for their advice meanwhile we also took advice from a rheumatologist who diagnosed a kind of arthritis and started treating accordingly he also started the course of defzacort steroid along with other medicines the steroid was prescribed with a decreasing dose per week from mg per day to mg per dayhowever after taking about two months of steroid course her condition deteriorated and had severe breathlessness her blood sugar level also shot up and ultimately she was hospitalized and the treatment of steroid withdrawn after days of treatment at the hospital she recovered to her previous condition but her neuro problem of numbness in her legs and loss of sensation in legs still continues please help ### Response: i have carefully gone through the details provided by you and have shortlisted the following possibilities the specific treatment for

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am suffering from a mild cold and severe clogging of ears i am taking afrin spray for an hour and one pill of sudafed i developed a similar condition of cold and sinus infection before six months i had severe clogging of ears i was given amoxicillin for five days and prednisone mg my ent doctor examined my ears and told me that there was no issue with the eardrum he diagnosed it as eustachian tube issue please help ### Response: take nasal spray once daily avoid cold spicy foods avoid smoking and alcohol avoid dust and pollution take some steam inhalation thrice daily

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my wife missed her periods and we doubt she is pregnant our first kid is just year old now and it was a cesarean we are not in a position to have a second child now her lmp was of last month i read that mifepristone can induce abortion is it a safe drug do we have to consult doctor for taking this drug what are all the possible side effects is that drug percent reliable is there any other options whether this drug is available without doctors prescription thank you ### Response: hello first please confirm the pregnancy with a serum betahcg test human chorionic gonadotropin as urine pregnancy test is not reliable till eight days post missed periods if the hcg levels are more than ngdl then she is pregnant in that case as she has been a post csection case medical abortion is not to be undertaken with either mifepristone or misoprostol simply because the csection scar would still be weak by one year and there are often chances of uterus rupture the best option in that case would be an ultrasound guided dilation and curettage procedure for surgical abortion please meet your gynecologist and get the needful take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a question for my mother my mother is years old she complains of episodic sudden loss of weight bearing ability on the left achilles tendon this has resulted in two major falls which resulted in trauma these are present for past few months and have become more frequent in the last month she also has pain in her knees bilaterally which has been attributed to osteoarthritis she also complains of hip pain associated with swelling and difficulty in standing lying and changing sides while sleeping there is episodic stiffness present in the shoulders which causes some discomfort in raising arms above the shoulder level she is taking bisoprolol mg and amlodipine mg for high bp and it is wellcontrolled she has no history of any allergy she has kidney stones and so occasional pain in the lumbar area she used to get constipation frequently she was hospitalized four times for normal vaginal deliveries and once for abortion she is monogamous with her husband she has a positive family history of hypertension in mother cad in father mother and brother and uterine cancer in mother she has a history of menorrhagia and cycles have become more irregular now then diagnostic d and c was performed last year which was normal she will not smoke or drink she sleeps to hours daily and snores at night ### Response: hello i have gone through your mothers elaborative history provided here along with the reports attached attachment removed to protect patient identity with this query

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: a few months before i developed a gastric issue that required treatment with ppis soon into using the drugs i developed headaches dizziness and nausea i changed the type of ppi three times but the symptoms persisted the symptoms included a feeling of pressure above my right ear and behind my right eye later i came off the ppis and after using over the counter headache painkillers for three days the severity of the headaches eased but the feeling of pressure remains to this day on the right side of the face i often feel heavy head or even lightheaded with a slight dizziness often as if i am hung over the symptoms come and go but are there every day for differing periods of time and the constant is this feeling of slight pressure on the right side of my head above the ear and extending sometimes down to the cheek and behind the right eye ### Response: hello i read carefully your question and would explain that the dizziness does not seem to be related to ppi adverse effects as it would have disappeared now for this reason i would recommend consulting first with an ent specialist in order to exclude a possible inner ear disorder which could trigger this clinical situation it is also necessary to perform a sinus xray study inflammation tests complete blood count pcr esr and thyroid hormone levels in order to exclude a possible thyroid gland dysfunction if all the above tests result are normal i would recommend consulting a neurologist for a physical exam a brain mri may be necessary i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i would like to ask what is the likelihood that my partner who performs oral sex on me has trench mouth or acute necrotizing ulcerative gingivitis he has no bad breath and he was able to have normal food can people with trench mouth have no bad breath and is able to eat normal food ### Response: hello i understand your concern trench mouth or acute necrotizing ulcerative gingivitis anug is a bacterial infection and is uncommon nowadays but it is highly associated with hiv infection and in kids with nutritional deficiencies to be diagnosed with trench mouth or anug symptoms like gum necrosis and ulceration pain and bleeding on just touching the gums should be present the main characteristic feature is fetid or the putrid odor which is caused due to the rotting gum tissue and people diagnosed with anug has this odor unless if they are under treatment in a very initial stage it is certainly difficult for people with anug to eat a portion of normal or even less spicy food if they are not under treatment it is treatable within a week by the usual antibiotic regimen and medicated mouth rinses gum infection such as this can not occur only by fellatio if your partner is diagnosed with immunocompromised diseases respiratory infection poor nutrition or has the habit of smoking practice caution during the act proper protection and oral hygiene practices will prevent such infections i hope this helps take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my son has developed anxiety symptoms about four years ago they came completely out of the blue he was with someone who now has heart palpitations sweaty palms and feet and lightheadedness sitting in the living room we ran a battery of tests when it first happened including tsh ekg lung scans blood panels etc and everything was normal so we went down the path of anxiety four years later the symptoms continued as my son now has a terrible fear of doctors we tried a home blood test to get a full thyroid panel i have attached the resultsthe blood work came back normal low normal tsh but low normal and lower normal free and free there is nothing that shows an abnormality however his urine test showed moderately low iodine and slightly low selenium i have read that abnormalities in these measures could cause thyroid problems what am i wondering is if these two indicators are worth further exploration with an endocrinologist knowing that going to the doctor will cause my son a severe panicalso is it possible that low iodine could have been a temporary diet thing and it is masking the signs of hyperthyroidism in the blood work he has all of the symptoms of someone with hyperthyroidism on a side note i am hypothyroid my sister is hypothyroid and my two nieces had hashimotos with my younger niece having thyroid cancer and got her thyroid removed at age of so everyone on my side of the family has thyroid issues we were wondering if you could please give us some guidance looking to see if we need to eliminate thyroid as a possible cause of his symptoms or if it is worth further pursuit ### Response: based on the details and the labs attached attachment removed to protect patient identity it seems very unlikely that the symptoms are coming from a thyroid issue urine iodine is really not helpful clinically in this case given the family history i would ask you to monitor tsh thyroidstimulating hormone once a year but that does not explain the severity of the symptoms at all for more information consult a diabetologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i think a spider went up to my right nostril yesterday morning and i am worried about it and frightened since then my nose has been blocked and sore ### Response: spider or any insect can go inside the nose mostly come through the mouth you are telling in the morning that means you aware of it you might have been sneezing or blow it the nasal block may be due to allergic mucus secretion if you are feeling spider struck in your nostril take clean water and inhale and bring it to mouth and spit it and see if still worried go to ent doctor and check it

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my symptoms are extreme nausea headache mainly right posterior and very stiff neck i started with a severe middle ear infection on the right side does my mri show any evidence of mastoiditis meningitis or a subdural empyema ### Response: hi your mri scan images are available and i have viewed it attachment removed to protect patient identity there is a mild bright abnormal signal intensity in the right mastoid area and the left side is clear abnormal signal in mastoiditis means brighter on and contrast images this can mean that you have a right middle ear infection which might have involved the right mastoid bone and this is known as otomastoiditis i have enclosed a picture of the area in a red circle in the attachments below there are no features of meningitis and subdural empyema for more information consult a radiologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am seriously facing acne pimples problem sometimes they occur on my face when i masturbate if i use mometasone it gives a good resultis it okay to continue this ### Response: hello acne is a universal issue in the age group of to years due to hormonal changes in adolescents however there are multiple effective treatment options depending on the grade and severity of the problem mometasone is a topical steroid and is to be avoided strictly on the face and for acne as it can harm your skin in the long run acne is dependent on hormones hence excess masturbation may sometimes lead to an increase in the problem i would advise you to stop mometasone immediately and kindly upload appropriate images to help us assess your current grade of acne and treat you better regards for more information consult a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my mother has a tumorlike thing in her shoulder it is like a soft pulpy thing right now it is small and not causing much pain when she works too much she feels a weight on her shoulder and a mild pain like she has lifted a weight is that something cancerous ### Response: thank you for using this platform it sounds like your mother has a soft pulpy growth on her shoulder which is painless at rest but causes heaviness on exertion although this information gives us some idea it is challenging for me to guess what precisely this growth is it will be nice if your mom could have it evaluated by an orthopedic surgeon he or she will assess whether this growth is arising from the subcutaneous fat example lipoma underlying muscle or bone or joint if there is a suspicion of bony or joint involvement an xray may need to be taken there is a rare possibility that this swelling might not be a growth but just a manifestation of trauma or infection i will be happy to review any pictures xrays or other imaging that you may have already done hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old my problem is the teeth has become white for the past few years the back portion of the teeth has become dark or black teeth are quite creamy often a bad smell spreads out from my mouth my mother also suffers from this problem i use whitening toothpaste but all are in vain so please doctor help me and give me a suggestion ### Response: hi i read your query and can understand your concern it seems like you have staining of teeth and plaque accumulation our mouth contains a great number of resident bacteria sometimes some individuals have staining bacteria which leads to physiological stains this is not any pathology or disease this staining often leads to plaque accumulation and bad smell from the mouth you need professional teeth cleaning scaling and polishing regularly usually every six months continue brushing twice daily with any toothpaste that suits you

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my year old son has some kind of rashes from last week we visited a pediatrician who suggested a dermatologist consultation i have attached images of the rashes and the prescription we noticed that it increases in the evenings every morning he wakes up with clear skin and during evenings it worsens he had a fever for two days around the same time it started he keeps scratching himself the severity has reduced but it is not completely gone ### Response: i have seen the images and reports attachment removed to protect patient identity the childs rash is called urticaria this is a nonspecific rash which may be due to food dust insect bite or a viral fever once it starts it persists for anywhere between to days and disappears completely afterward zempred methylprednisolone and levocet levocetirizine are the right medications for this condition there is no need to be alarmed about this this is a minor rash which will settle in few days i advise you to continue the same medications for more information consult a cosmetologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i sustained an injury recently and i had an xray the xray shows i have an intraarticular fracture of the right fifth metacarpal with significant ulnar displacement for consideration of orif i went to my local hospital and they did a ct scan they sent me home and said to wait for their call to be seen at the fracture clinic i have only buddy taping on my little and next finger people are telling me it should be strapped or cast right away i am worried ### Response: hello you need to take rice rest ice compression elevation treatment rest with buddy strapping with length achievement and plaster slab application ice application twice daily before the slab compression bandage with elastocrepe bandage inside the slab elevation keep the limb elevated as much as possible if the length of the knuckle is not achieved by nonoperative methods then surgery will be required this professional advice provided by me stands subject to the actual examination of reportimage and is based entirely on inputs provided to me it should be correlated with clinical findings for more information consult an orthopaedician and traumatologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my fiancee had a bleeding on the of last month it lasted for about four to five days she then got dengue and on the of this month had mild spotting for a day and a half the doctor said it could be the dengue causing the spotting she has not gotten her periods yet i have read that there could be bleeding during pregnancy as well ### Response: if she had her period on the of last month then there is no chance that the bleeding on the of this month was due to pregnancy if it was due to pregnancy then it should have come around the of this month so do a urine pregnancy test first for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i recently have noticed a slight blurriness in my right eye it is only noticeable when i close my left eye and so i am not sure how long it has taken for this to develop i am going to see an optometrist and doctor early next week but am currently on the road for workmy main question is that when i look out of the corner of my right eye the blurriness seems to subside and i can see usually i am wondering if this is a good sign i have been dealing with severe anxiety the past couple months and i am worried that might have raised my blood pressure enough to hurt my eyesighteyesight when looking with both eyes seems to be normal i have also noticed floaters in my eyes kindly help ### Response: hello this kind of a picture of eyesight becoming better on looking at specific directions are related to astigmatism it is a very prevalent and correctable condition there is no need to be anxious about it different reasons cause floaters a dilated retinal examination will be able to help us get to the cause most of the conditions causing floaters are benign not severe but a few are dangerous but all are treatable so i recommend that you visit your optometrist and in case you need any further information or help with refractive surgery please schedule a consultation i hope this helps you

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female i am kg feeti am currently experiencing shortness of breath it started a week ago and never went away even though i am taking lagundi or herbal cough medicine mg three times a day after meali also feel like i have a lot of phlegm that i can not release it just feels heavy on my right chest that passes through my back i am having paranoia on having but i am afraid to get checked because i might actually get it from the hospital please help ### Response: hello i understand your concern i do not think it is as you do not have a fever but you need an antibiotic i believe it may just be pneumonia for you should have a fever cough and difficulty in breathing

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my wisdom tooth present in the lower left region is growing i have a sufficient space for it to grow and it is growing straight i do not have pain in the tooth and half of the tooth is poking out now but i have trouble in opening my mouth fully ### Response: hi i can understand your concern an eruption of wisdom tooth cause difficulty in opening the mouth fever swelling in gums pain and neck swellings you do not need to worry restricted mouth opening will get relieved after a few days still to get relief you can take tablet zerodol mr acelofenac with tizanidine two times a day for three days after taking food take tablet pantoprazole mg one time a day for one week take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a female height cm and weight kg i had two ipills in one month after the first ipill i got withdrawal bleeding after five days it lasted for four days and the flow was normal after days of this incident i again had protected sexual intercourse and took another ipill after hours but this time even after days there is no withdrawal bleeding is this because of hormonal imbalance or pregnancy ### Response: since you have taken an emergency pill within hours of intercourse there is no chance of pregnancy this could be because of hormonal changes due to the pill you have taken so relax and do not worry but please do not use the pill so frequently as it is a hormonal pill and can cause hormonal changes in the body take care for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have been treated with for a yeast infection and given antibiotics last month end and then last week had another infection milky like discharge no smell is it advisable to wait for one month to be seen by my gynecologist or go to an urgent care right away ### Response: if you had a yeast infection you would have been treated with antifungals and not antibiotics since you have a recurrence after being cured with the first treatment you should be examined to see if it is similar or different infection now and treated accordingly tract infection should get urine routine and microscopy test with midstream sample to see if you have associated urinary tract may require a pap and postprandial blood sugars clotrimazole vaginal pessary at night daily for one citralka one teaspoon with one glass of water thrice daily for one week sugars if you are your private parts

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my father recently had a heart attack and a stroke then had two heart valves repaired and they want to put a stent in his list of medications does not seem to make sense and although he loves his cardiologist i do not think he is paying enough attention i am in the medical field and although i am not a pharmacist or an md i know a little bit about adverse drug reactions tell me if this makes sense to youmetoprolol tartrate mg half pill twice a day potassium chloride meq once daily losartan potassium mg once daily warfarin sodium mg once daily atorvastatin mg digozin mcg once daily and furosemide mg once dailyi need to know if these medications are fine to take all in one day and if so i would like to split them into two times a day according to the reactions i feel that so many medications doing the same thing is redundant and unnecessary and causing problems please help me ### Response: hi let us evaluate all medications your father is receiving diagnosis valvotomy cad with mi coronary artery disease with myocardial infarction and cva cerebrovascular accident recovered tablet metoprolol is essential in patients with heart attacks as it slows the heart and keeps it healthy so we can not omit that the dose is already very low and so we can not reduce it further tablet losartan again essential in people with heart attacks the dose is already less and can not be reduced but yes the timing can be changed to alternate with metoprolol one in the morning and one in the evening the danger is giving potassium tablet losartan and digoxin and can cause increased potassium levels and giving more potassium is highly dangerous the doctor might have given for some time but it has to be stopped now warfarin is given for stroke prevention mg is a minimal dose it can not be removed as stroke prevention is essential timing can be made flexible atorvastatin is for heart attack prevention ideally can be taken at bedtime frusemide is a diuretic there is no specific reason to give this in your case the only issue i can think of is because of the valve surgeries they want to keep blood volume low this can be discussed and removed ideally can be given in the morning about aspirin it should not be given when you are giving warfarin remove it if it is still on if the blood becomes very thin then there are chances of brain hemorrhages i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have got an ear itching five days before and went to a doctor the doctor has told me that my ear got affected with fungus and prescribed otinex ear drops i continued that for three days initially i got pain and liquid discharge from ears now pain has gone but slight liquid discharge and ear block is still there kindly provide suggestions ### Response: did your doctor look into the ear using an otoscope or endoscope if so and then he diagnosed as fungus then it is fine do not let water enter the ear while taking bath or swimming in my set up i give ciplox ciprofloxacin and candid clotrimazole and lidocaine ear

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: so i have hives also known as chronic urticaria basically i break out when the climate i am in is hot or when i exercise i visited my family doctor and he told me to get a blood test and he also gave me a cetirizine zyrtec prescription which is mg i have been taking this medication for about four days now and i still get these itchy hives if i were to get a blood test will the doctor be able to prescribe the right medication so i can get rid of these annoying hives ### Response: hello the blood test should determine what allergen is causing the problems in you sometimes it can be a combination of allergens once we know that we help you avoid the same and prevent the sensitivity reactions allergies and hypersensitivities are not cured by medicines allergen avoidance plays the major role additionally we can give you immunotherapy if the problem does not resolve for more information consult an allergy specialist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my friend underwent a usg and she was detected with pregnancy and then she took mifepristone and then next day four misoprostol mouth dissolving now it has been more than hours she is bleeding continuously with clots and having severe pain kindly suggest what to do now for pain and bleeding ### Response: it is the pregnancy products coming out heavy bleeding is expected after medical termination of pregnancy sometimes however if the medical abortion is not complete and some products remain stuck in the uterus the bleeding may continue or even be excessive to a level where you need to visit an emergency the medicine should be taken under the strict supervision of your gynecologist

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have hydrocele for so many years but as it is not showing any problem so i left it till now but now i want to go for hydrocele surgery also i want to know any other methods except surgery which can be done to finish hydrocele now i am also going to gym and doing some physical exercise there is there any problem with it my age is years height is and weight is kg ### Response: hello but sometimes an infection can occur as a complication and i will advise you to get it repaired surgery is the only management and it is not muchcomplicated operation so do not worry mild exercise usually will not affect it take care for more information consult a family physician online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have protected sex with stranger and after that i get inflammation in urinary tract should i get worried about it ### Response: hello if you have symptoms of inflammation of urinary tract than you have to rule out urinary tract infection for that i suggest you investigate with urine routine microscopic examination report and urine culture for primary workup you can revert back with reports once done cranberry juice extract tablet also needs to be taken for seven days you have done protected sex so chance of sexually transmitted diseases is very unlikely

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a back to back unprotected sex with my partner for three days in this month and my expected period date was six days later i have taken unwanted on the third day morning after having breakfast but still my periods have not yet started can you please help me out with the reason behind that ### Response: since you have taken the emergency contraceptive pill within hours of intercourse then there is no chance of pregnancy so relax and do not worry you will definitely get your periods do not take any medications without an expert advice however if you have a doubt then get back to me for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was having spotting most of the month then heavy bleeding for two days i then passed what looked like grey muscle and suddenly no more blood what does that mean or what could it be ### Response: hello it is suggested that you may get a urine pregnancy test done as this fleshy mass passed could be an abortus considering that you have been spotting throughout if negative then you shall need an ultrasound pelvis to check for endometrial thickness to rule out proliferative phase disorder take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my son is six years old he has nasal blockage for the past two weeks now he has developed a fever his throat and tonsils are swollen we took him to a doctor the doctor prescribed him benadryl ml and crocin ds ml he has not given any antibiotics is it fine please suggest ### Response: do not worry you can give augmentin dds syrup gm by ml amoxicillin with clavulanic acid twice a day for five days along with the abovegiven medications

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my vision was crystal clear this morning i just woke up from a nap and the vision in my left eye is blurry it has not cleared up in the past half an hour twice over the years this has happened and it normalized over a few hours but i am in a jungle now so i would like to err on the side of caution i have had previous retinal detachments ### Response: hello did you get any surgery done for retinal detachment earlier it may be a recurrent episode of retinal detachment if you have diabetes or hypertension that may be a cause of this detachment it can also happen in vitreous hemorrhage in which you will see a slightly reddish vision and will not clear up if this is the case then it will clear up in few weeks what is the exact cause can be told only on examination you should rush to the emergency asap if detachment surgery is required then visual prognosis depends on the time elapsed between episode and surgery so you should not delay there is not much you can do at the moment by yourself just seek help from someone to reach a hospital for more information consult an eye care ophthalmologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: last night i fell from my bike on my right side as it got slipped while driving my right hand and right shoulder directly hit the road and cause severe pain on the right side of the abdomen a local doctor prescribed some medicine and i got relieved from my side pain i went for an xray of the right chest it was normal but after hours i am having pain in the right shoulder scapula and while sitting or arising out of bed or moving hand on the upper side the pain increases a lot is it normal or need better medical assistance ### Response: you should get yourself examined by an orthopedic surgeon and xray of the shoulder region is required any pain in the shoulder after trauma requires evaluation and any pain can not be considered as normal there are chances of soft tissue alone with no bony injury but i would recommend a reevaluation till then you can apply ice to the affected area and take analgesics for pain relief kindly follow up with your xray and feel free to discuss further

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my lab tests are as followsseven months ago blood glucose of mgdl gtt one hour mgdl two hours mgdl morning insulin xcexbcuml this month bg mgdl gtt one hour mgdl two hours mgdl morning insulin xcexbcuml every other blood test within normal ranges i am male years old cm kg to body fat athletic with healthy nutrition habits no history of diabetes in the family could i be having cancer in pancreas judging from the insulin values you are seeing i have had many years to do a blood test and with this random one seven months ago i was told by my doctor that i had to keep monitoring my blood glucose since i could develop diabetes later on and since i have never had a problem with blood sugar as a kid and no family history of diabetes i was wondering what might be going on cause insulin levels dropped from my last test and since my diet was pretty much same with healthy choices why is this happening my doctor for the last seven months kept telling me to calm down and that i do not have anything cause stressing is bad for my blood glucose too should i be telling him to get a pancreas mri done ### Response: pancreatic cancer does not have these manifestations at all so testing for cancer without any strong family history or clinical manifestations is just not recommended continue with your healthy lifestyle and try to workout more as they reduce insulin resistance and thereby decrease fatigue of your pancreatic cells for more information consult a diabetologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have noticed that my first molar is loose i keep pushing it with my tongue and clenching a bit against it and i just noticed that it has become loose little more i have my wisdom teeth and i think it might be applying pressure forward on these teeth i read in a book that day grinding can cause a teeth to loosen which is easier to treat there is no pain and the teeth look healthy i always clench my teeth but it never caused any looseness ### Response: hi i have gone through your query and you are having a habit of grinding your teeth during the night that is called as bruxism and the symptomatic treatment for that is the use of mouth guards i recommend you visit a dentist and get it checked your treatment depends on the grade of mobility so i am not quite sure about what grade of mobility you are having the mobility can be in grade or grade if it is in grade it will resolve on its own and if it is in grade you need to go for scaling and root planing that is a minutes procedure done only in the surgical environment you can get mouth guards for your nightwear at any sports shop or get customed ones by giving an impression of your dental arch at the dental clinic for more information consult a dentist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: we have a baby girl she has five brown marks two of them are cm size and the other three of cm they are irregular in shape initial two marks appeared when she was months old and now when she is months three more for added that are comparatively light and cm of size are these birthmarks will they fade with the time do we need to take any precautions so that they do not increase or get added further can we also provide any medication to cure them ### Response: hi please send me a photograph of the lesion on the basis of history it seems to be cafe lait macules but to be sure i need photographs of the lesion presently i will not suggest any medications as baby is small and i need to be sure kindly review with photographs take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have red raised rashes in my legs and arms i used hydrocortisone cream but there are no changes in it please help ### Response: i have gone through your case it could be insect bite reaction follicular eczema contact eczema please follow these instructions please wear loose clothing while you have this rash as tight clothing like jeans rub your skin and itching start and as a result of itching these lesions develop mix hy

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have been going to a dentist about a tooth that is sore they started a root canal but then did not finish i have gone back several times and every time they open up the tooth and insert medicine my tooth is in agony right now i am just wondering if this is a standard procedure during a root canal should not the dentist remove the nerves so i am not in so much pain or is it the standard procedure to fight the infection first and then remove the nerves ### Response: hello i understand your concern the number of sittings in the root canal procedure depends on the amount and extent of infection antibiotics and painkillers will be prescribed for the next three days to control the pain and infection after three days the root canal treatment can be done painlessly once the nerve had died from your query and the details provided it seems like you are having a challenging tooth quite a lot of infection curved roots pulp stones etc a clear picture of your tooth xray will help to identify the problem talk to your dentist and get to know what is causing this pain and delay in treatment i hope this helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i have pain in the corner of my left eye for the past one year i went to the doctor and he gave me sterdex i used it and felt better my pain went away after a few months i started to have pain but it was not so severe as the first time i wear glasses and lenses and i am treating my eye allergy with chibro cadron ml and for dry eyes i use fluidabak after taking the lens whenever i do my yearly eye checkup my eyesight gets worse because of the pain in the corner and i am scared about my sight i do not know whether i use an appropriate medicine to my eye whenever i consult the doctor he gives me the same medication please help me ### Response: hi minimize the use of steroids as much as possible to avoid side effects such as an increase in eye pressure leading to glaucoma both sterdex dexamethasone and chibro are steroids they may relieve your symptoms in the short run but may harm your eyes if used for long term pain in the corner should not affect your eyesight just use appropriate glasses for allergies olopatadine containing take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i just had an egd with biopsy polypectomy it showed a hianal hernia cm i am attaching photos the doctor took biopsies said no cancer i have had breast cancer in the past i am having pain in the chest when i swallow and sternum today will that subside is it from the bleeding and can you recommend the best pill to take for this pain taking pantoprazole now and what should i take for this problem what should i eat can you assure there is no cancer ### Response: hi i have gone through the reports of your endoscopy attachment removed to protect patient identity as per the endoscopy you do not have any evidence of cancer have you received the reports of biopsy if so please forward it the medications you have taken are appropriate if symptoms persist may consider doing a highresolution manometry continue the same medications may add gaviscon tablet after major meals for one week refrain from lying down for at least for two hours after food elevate head end of the cot by six inches restrict citrus fruits restrict tea and coffee to two cups per day

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am male i am cm in height and weighs about kg i would like to know about testosterone injection if i took it in a small dosage weekly will that help my appearance to be more manly even that my appearance is manly but in general my physical built is small compared to other men my face hands legs are small also my voice is femininemy testosterone level is good my body is too hairy and i did a testosterone test everything was normal i know there is a lot of studies that say that testosterone can lead to depression but actually at the age of i was suffering from depression and i took testosterone for a month to gain muscles my mood was very good and it actually helped my depression also my sexual life and erection are very good i do masturbate once or twice every two days and i get an erection easilykindly help me with these questionswill testosterone injections help me be more manly what is the recommended dose that i have to take monthly what are testosterone injections made from are they made from an animal source will testosterone affects my personality do i have to take it for life what if after some period i decided to stop will i loose what i gained ### Response: i have read and understood your problem testosterone injections have beneficial effects if only blood testosterone level is low otherwise it may harm you in several ways for a more manly look the best solution is to do exercise i have answered your question in the same order testosterone injections will not help to be manly unless your blood testosterone level is low if the blood testosterone level is low even then injections of hcg human chorionic gonadotrophin or oral clomifene is a better choice mostly testosterone injections are synthetic it will not affect your personality if the blood level is normal if the blood testosterone level is low then you may need longer treatment but the effect is temporary you may loose what you gained if you stop injections

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: is there a difference in alcoholic and nonalcoholic mouthwash which is better at combating bad breath due to smoking than alcoholic i am in a hygiene school and want to know whether or not to recommend nonalcohol mouthwash for the complaints of bad breath from smoking i have recommended tongue scraping alcoholic mouthwash anyways they are not going to stop smoking or drinking i was looking at a way to have them not dry out the tissues but stopping the obvious factors do not seem to be an option ### Response: hello you can definitely prescribe alcoholfree mouthwash in such cases in fact they are better in the patients who consume alcohol and smoke alcoholfree mouthwash should not contain benzalkonium chloride allergen sodium lauryl sulfate saccharin or alcohol on the other hand it should have sodium benzoate sodium bicarbonate and other ingredients that actually help to eliminate bacteria from the mouth you can check the commercially available mouthwashes in your country

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have been diagnosed with mild hereditary spherocytosis my eyes still yellow is it unlikely hematologist who diagnosed me three years ago misdiagnosed i do not doubt he knows his stuff more about me getting worried i lost weight a couple of months ago i went very yellow in the eyes i have always felt tired i have had gallbladder out four years ago i bruise easily i do get little red skin dots at times menstrual cycles can be irregular and spleen slightly enlarged ### Response: i have gone through your lab reports attachment removed to protect patient identity and they are consistent with the diagnosis made by your doctoryellowish tint of the eyes is due to increased bilirubin levels this is due to the increased red blood cell destruction in the spleen and is commonly a complication of hereditary spherocytosis it is understandable that you are feeling weak since your body is producing red blood cells at an accelerated rate to compensate for the destruction occurring in the spleen this is also the reason why your spleen is enlarged if your condition worsens your doctor might suggest a splenectomy this will not cure the condition but will relieve the symptoms since the site of destruction of red blood cells will be removed and your red blood cells will be able to survive for a longer period in the blood splenectomy however can predispose one to certain bacterial infections and it is important that you receive the appropriate vaccines regularly you could take folic acid and vitamin supplements since one of your blood tests show macrocytic anemia for more information consult a hematologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my height is and my weight is kilogram my ovary is bulky with right ovary volume cc and left ovary volume cc i am suffering from pcod i am under treatment for the past three months can i get pregnant naturally ### Response: it is one of the most common reasons for the irregular menses especially oligomenorrhoea you have to be placed on low dose oc oral contraceptive pills with myoinositol supplementation with a reduction in weight with exercise and diet by increasing your daily water intake all these are followed for the treatment of pcod you can conceive naturally if the ovulation maturity is reestablished with the treatment or else you may need assisted techniques for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am suffering from an infection on my penis i am using clotrimazole cream over the infection once i miss applying cream a day the penis gets infected with red patches pusfilled boils and there is severe itching my partner is not affected by any problem though we are sexually active i am not diabetic when i saw my blood test kindly help me to cure it i am frustrated with my problem kindly give me medical advice ### Response: hi please send photos of the affected area before applying clotrimazole cream after seeing your images i can give my comment about your problem revert with more information to a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i wanted to know if you could answer one question for me i experienced an episode that lasted roughly about two to three minutes where i felt that i could not seem to catch my breath and it felt as if my heart had stopped beating i checked my heart rate roughly three minutes after the incident and it was at bpm and my oxygen was at under two weeks ago i had a routine tape which was clear ectopic beats picked up but were benign i suffer from anxiety and panic attacks however they generally come on during stressful situations could this be a panic attack symptom i also wanted to add that this happened during intercourse i am a male height is cm and weight is kg i look forward to your response and suggestions ### Response: this can be a cardiac arrhythmia like psvt paroxysmal supraventricular tachycardia or atrial fibrillation in which heart rate suddenly goes up and also suddenly decreases and one may get symptoms like shortness of breath chest pain or heaviness dizziness etc are you having ventricular or atrial ectopics have you undergone echo presence of ectopics also suggests the possibility of these arrhythmias usually ecg is normal attachment removed to protect patient identity as it is done in between the episodes or may show ectopics ecg done during episodes will show abnormality you may request for portable cardiac monitor either holter or another mobilebased rhythm monitor especially during intercourse to see the rhythm is recurring alternatively you may undergo treadmill test and we can see if it recurs during the running also thyroid test should be done if not had recently ln order to abort such episodes you should try to cough hard next time you have this focus on heart rate and measure pulse rate these arrhythmias are not lifethreatening so overall that episode may be an episode atrial arrhythmia rather than panic attack and our priority is to confirm it by investigations hope this helps you and get back if you have any doubts for more information consult a cardiologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: can you please help me understand my test results my platelet count is at and my doctors are unable to give me a specific reason for it ### Response: i have gone through your reports attachment removed to protect patient identity take care consult your physician for an examination keeping these points in mind hope your concern solved for more information consult a hematologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a known diabetic for the past years days ago my was i am years old and my weight is kg my medications are metformin mg hcl mg istavel mg and glaritus insulin units even then the sugar levels are and after every three hours today my creatinine sgot sgpt and tsh are normal ### Response: i have a few questions for you as i would like to know more about your diabetes history revert back with the answers to the above questions to an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: when i have the fever can i take cetirizine in the morning and then paracetamol in the afternoon ### Response: you mentioned that you have the fever you can use paracetamol you can take it up to three times a day and can stop if your temperature comes down now coming to cetirizine it is used for allergy cold etc if you are having a flu type of fever that is fever with the cold or itchy throat then yes you can use it along with the paracetamol i suggest you take both the medicines together you can use levocetirizine which avoids sleepiness hence you can be focused in your work consult your specialist doctor discuss with him or her and take medicine with their consent

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have small white and yellow lesions with a red border on my tongue my tongue also develops a white coating that has to be scrapped of daily i have attached a photo of the same what are the likely causes ### Response: hello i have gone through your complaint and the attached picture attachment removed to protect patient identity i hope this answer will help you for more information consult a dentist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: three days ago i had my atlas adjusted and now for two days the lymph nodes cervical lymph nodes in my neck have been extremely painful and swollen for the last two days i have no fever or other symptoms should i be concerned i had my atlas which was supposedly two degrees off by an atlas orthogonal chiropractor i originally went in because of my knee and wrist pain then before i knew it i was having my atlas adjusted by a machine my last few days i have been miserable and feeling awful exhausted my lymph nodes are so painful on the sides of my neck i have been in bed all day i just feel this might be related but i do not know ### Response: what i see there might be some changes in the muscles which may have led to compression over the lymph nodes few basic things to ask before i proceed are you having pain in the neck is the pain sharp shooting or dull aching are you feeling any kind of muscle tightness near the neck any signs of swelling the pain in the knee and wrist can be of different pathology and need a different approach coming back to the history the swelling in lymph node if you suspect then you need a physician approach than the chiropractor we need to check out why the lymph nodes got swollen is it due to any pathology or due to some external factors usually this area does not allow lymph nodes to get swollen sooner until there is some pathology and it is always good on our side to take care of our body in proper guidelines hope you take this matter to a physician first rather than a chiropractor as per my practice of years i never recommend cases with lymph node issue to chiropractor as the job is different degenerative disc disease mri cervical spine trapezitis neck pain ice pack and rest

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am feeling really down i have had a lot of digestive problems for about two years i have been diagnosed with candida and dysbiosis but my regular doctor does not seem to know what is wrong with me i have been very stressed and have suffered anxiety since i was about i was not on any medications and started taking cymbalta a few months agoafter about three to four days i started to notice a bit of burning in my feet i have since stopped taking the cymbalta about a month ago my feet seemed fine then seven days ago i have started getting really bad pain in my feet and burning and tickling and pins and needle feelings i am not diabetic or alcoholic i have no idea what has brought this on or whether it can be reversed i am so stressed out i have to be on my feet for my job for about four and a half hours every morning can this be tested to see if the nerve cells are either dead or just damaged and can it be reversed this feels like it is going to ruin my life please help ### Response: regarding your concern i would agree with you on the fact that your symptoms could be related to a peripheral nerve damage coming to this point i would recommend consulting a neurologist and performing an ncs nerve conduction study to examine your nerves other tests to investigate the possible causes of your symptoms would be you should discuss with your doctor on the above issues for more information consult a neurologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have blood dots present under my skin but it appears only in my arms i have them on a different arm every morning i do not have itching and they are not raised ### Response: hi i have gone through the attachment attachment removed to protect patient identity these are called petechiae it can occur due to multiple causes please mention about the other clinical complaints you have please report about the recent history of trauma

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a silent missed abortion last year in the third month of my pregnancy after that i got some tests done which resulted in cmv igg positive then i got vaccinated for rubella to prevent any casualties in the next pregnancy now i want to try and conceive but just now i got my torch panel done again and now the hsv igm is positive with range along with cmv and rubella igg positive should i wait or can i try to conceive right now my husbands torch panel also done nothing abnormali am currently under folic acid and multivitamin for now to conceive faster and also a homeopathic medicine for migraine ### Response: yes you can try for your pregnancy as igg immunoglobulin g means that you do not have any current infection it is only due to prior exposure and for hsv the only thing you have to watch is the presence of active lesions otherwise there is no other reason not to try for pregnancy you must try for it whenever you and your partner feel ready to do so secondly abortion is a very common thing in reproductive age and only after one abortion there is no need to undergo all these extensive investigations i hope it has helped you

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: it is regarding my son he is months and week old he has not started to walk by his own but started to crawl since months is there a problem with his leg muscle ### Response: hi do not worry the very fact that the child is able to crawl shows that leg muscles are working fine and have enough strength to lift the weight of the body give the child some time and he should be able to walk also you can supplement the child with calcium and vitamin d for providing more strength and nutrition for more information consult a child health specialist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was suffering from an infection in my tonsil for the past four days i went to an ent specialist four days ago he told me there is an infection and advised me antibioticnow my pain in the tonsil has gone but i am still feeling something stuck in my left side of the throat where there was tonsil pain i do not have any problem with swallowing kindly advise me the needful ### Response: probably the infection got resolved but the enlargement and hypertrophy of tonsils remain you need to take a picture of the open throat showing both tonsils and send to us if the enlargement is very big and causes significant symptoms recurrently we can remove the tonsils by tonsillectomy operation in some individuals after infection the tonsils remain slightly big giving a feeling of something stuck down the throat for more information consult an ent otolaryngologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: around a year ago some red pimples started appearing around my mouth chin forehead and my nose these small red pimples create a red area when seen from far away because they are very small and inflamed it never disappears my skin always feels stuck and not flexible and with a mildly itchy or burning sensation no matter how much moisturizer i apply it does not help i am using eucerin atopic control moisturizer and a gel cleanser with hyaluronan i even tried using metronidazole and tea oil but again it did not help i have also tried to stop using anything on my face for some days but it stayed the same i am years old now and i never had acne tendencies when i was a teenager and my skin always looked very smooth my birth control pill is still the same as it was when i first started taking it which wad around ten years ago i do not use steroid creams nor fluoride toothpaste how can i get rid of this it was not there before a year i am attaching a picture of my face thanks ### Response: i have seen the attached image attachment removed to protect patient identity do not apply metronidazole gel as there is also erythema over your face i suggest you try doing the following consult your specialist doctor discuss with him or her and start using the medicines after their consent for more information consult a dermatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i asked a question to you this morning you advised me not to take contraceptive pills since i have the diu mirena but i have another question you are right i have been feeling my body temperature too high and my last period almosts last seven days here is my question there are five pills left in the blister and because of your advice i would like to quit right now from taking pills is it alright to stop now or should i finish the pills this month and then stop taking them ### Response: hi it is better to take the leftover pills for this time and then avoid taking any pill until you have mirena take care for more information consult an obstetrician and gynaecologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am coming here for what i think may be possible lower back muscle spasms i originally felt the pain after playing lots of baseballs swinging a baseball bat many times i have symptoms such as tightness limited mobility or restricted range of motion throbbing pain and sometimes it gets so bad that it became hard for me to even walk or sit i went to my athletic trainer a month ago and she told me she thinks it is just an aggravated muscle spasm so she told me to just give it some rest from the activity that hurt it so i gave it about a month in which it seemed there was no pain but as soon as i tried to do the activity that hurt me in the first place it went right back to hurting it would be of great help for any assistance what should i do now ### Response: i read your concern i feel that spasm could be due to less core stability and excessive spasm invariable loading hip joint reducing its range on movement i would like to suggest you get more insight of your symptoms like is there any pain on bending forward touching the floor or arching back or inside bending i recommend you to kindly do apply ice frequently over the painful area a lot of frequent stretching for gluteus hip flexors and oblique muscles a back extension like cobra stretches at least three times in a day keep icing every time after stretch core stability exercises kindly do these for two weeks and revert back to me

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my partner had a miscarriage unknowingly that she was pregnant five to eight weeks maybe she had negative home pregnancy tests a negative test at the doctor and had a miscarriage the next day after doctors test my question is could it be possible there is another fetus remaining inside i only ask because we each have one parent that is a twin please adviseshe thought she was on her period the entire week bled for seven days sheattributed it to the planb pill she took several weeks back we hadunprotected sex but i still pulled out she is on birth control andused a planb pill how is any of this miscarriage stuffpossible especially after just seeing the doctor the day beforemiscarriage ### Response: hi if bhcg betahuman chorionic gonadotropin test or urine pregnancy test says she is pregnant then we can say she is pregnant and if bhcg test is positive and healthy if it is decreasing with the history of bleeding then we can say it was a miscarriage or we find a fetus part in ultrasound scan or test bleeding parts then we can say that it was pregnancy it can be possible the twin part i can not say need to do an ultrasound scan to check the status of pregnancy sometimes early there is implantation bleeding only

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i was diagnosed with dysphonia about a month ago i have had a couple of speech therapy sessions but progress is glacial i am still hoarse and in pain i have been on mg of omeprazole for a month and gaviscon double action for two weeks i feel like the back of my throat is still swollen and i have pain in the corners of my throat this only briefly eases when i really do some throat opening exercises i can not talk for very long without everything getting sore still i have been like this since the beginning of the year since i had a chest infection and pneumonia my mouth is now getting sore from all the gaviscon tablets as the liquid irritates the corners of my throat i really do not know what else i can do i am having panic attacks and starting to feel like the only option is to take my life i had a post nasal drip for most of the year so far and i am trying to get my salivary glands to work again properly ### Response: muscle tension dysphonia takes time to get cured a few sessions of speech therapy are not going to rid you of the problem muscle tension dysphonia occurs due to various reasons and can be present after laryngitis or pneumonia as in your case as an ent surgeon i would like to see the laryngoscopy video myself to ascertain if indeed the false vocal cords are producing voice instead of the true ones dysphonia plica ventricularis is the grade of muscle tension dysphonia dysphonia plica ventricularis is when the false cords medialize to produce voice continue the speech therapy and antireflux treatment like your ent surgeon and audiologist has prescribed the speech therapy is aimed at suppressing maladaptive phonatory mechanisms and learn techniques designed to minimize muscular tension do write back to us if you need any further information on this but at the same time please be patient with this problem to get resolved take adequate voice rest and whenever you use voice take care not to raise the voice or use unnatural frequencies for more information consult an ent otolaryngologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had a secondary burn on my calf after a month of selftreating it just got worse i play soccer and that and the sweat is what was irritating it so i finally went to the doctor and they prescribed me smz tmp ds i took it for about a week until i realized i was having a lot of side effects and an allergic reaction especially around my mouth at first i thought i was just breaking out then it was not like sores or blisters i kept selftreating the rash around my mouth and stopped taking the antibiotics for a couple days it was gone i was happy then i was in the sun one day for soccer and it was just like another rash but worse i stayed home from school did not do anything because i just wanted to get it better but now it looks really bad i believe i have perioral dermatitis it is red patches all around my mouth it is really dry and scaly also there are like whiteheads around my mouth also but they are not whiteheads i would try to moisturize it with coconut oil or tea tree oil but i think that is what made it worse ### Response: i have gone through your case right now you have applied too much moisturizer attachment removed to protect patient identity if blisters or erosions are present then you may need oral steroid as well sometimes a sulfa group of

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: attached is a treadmill stress test result i would like to obtain technical info regarding these results particularly regarding the infarction i would appreciate the severity of this infarction and whether it could be a machine error could you also tell me by perhaps drawing on the shot what waves and shapes indicate problems ### Response: i have gone through your report attachment removed to protect patient identity it is unlikely to be a machine error errors do not have such patterns and it is suggestive of old infarction only its present in inferior leads which suggests inferior part of the heart is damaged and these are relatively less severe kind of infarction however an echo will give a better idea regarding the severity and extent of damage done so it is better to get an echo done if not done yet now you can see in lead p wave followed by a sharp spike called as qrs complex followed by an upright wave called as twave so now you can see in lead and avf which are inferior leads showing downward qrs spike instead of upward and twave is also inverted suggestive of heart damage so the next step is an echo to look for the extent of damage and followed by angiography to see the blockages and if needed then revascularization hope this helps you and get back if you have any doubts for more information consult a cardiologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: if tsh range is does it mean any problem ### Response: hi tsh thyroid stimulating hormone test is done to check for thyroid function of the body the normal range that can be considered within limits is up to since your value is it falls in the higher range it means you are suffering from a condition known as hypothyroidism you will need to start medications for the same i would suggest you consult a physician who will treat any associated symptoms you are experiencing and also start you on medications

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have one white lump around the tonsil area in my throat it has been there a good few months now and the area is swollen is this cancer ### Response: hi cancer can not be diagnosed by inspection only to exclude tonsillar stone you have to perform lateral neck xray and show me it later on i advise you to use a mouthwash and gargle your pharynx then expectorate it many times during the day for a week then if the white spot still exists you may have to undergo tonsillectomy then examine the tonsillar tissue histologically to detect its nature for more information consult an entotolaryngologist online take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a best friend who suffers from anxiety and i saw her almost dying today because of a panic attack she had all her life she thought she had a problem with her heart but she went to see a doctor and he said she is in perfect health she starts shaking and can not breathe and i am really scared and try to calm her down but she can not breathe she can not stop shaking for at least half an hour i do not know what to do and i hope you can tell me ### Response: panic attacks related to anxiety can be a scary experience but remember it is not a lifethreatening experience you can encourage your friend to seek professional support to manage her panic attacks and anxiety she will need a complete assessment following which talking therapy and medication can be prescribed meanwhile she can try progressive muscle relaxation exercises and deep breathing techniques to help reduce her stress levels you can contact us again if further advice is needed

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had elevated alt levels between for the past one and half years with slight enlargement recently i have elevated ast levels there is no hepatitis or inflammatory diseases alcohol drug use or fatty liver or addisonsliver biopsy showed inflammation but a resolving process likely attributed to a year long lyme disease treatment with various pharmaceuticals but discontinued two years ago liver enzymes dropped to alt but have recently elevated to altat this point there is no known cause i was told to continue to wait and see i would like to take a different approach and determine if there is something my hepatologist is not seeing the current medications are lamictal and gabapentin trazodone i had abdominal ct abdominal mri liver biopsy ultrasounds and a significant amount of blood work ### Response: you should not wait there is some cause that is creating an issue for the liver it is continuously damaging your liver all these three medications are reported to cause liver injury though this is more common with lamotrigine case have hepatotoxicity and less common with rest two and only described in case reports to prove dili we need to rule out other treatable causes of liver disease dili is a diagnosis of exclusion most common causes are nonalcoholic fatty liver alcohol autoimmune hepatitis hepatitis bc cholestatic and muscle disorders we need to evaluate as soon as possible to prevent the further damage to the liver first we need to diagnose the liver disease secondly we need to quantify the damage severity for prognostication probable cause

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have a small pimple on the penis and testicles for the past six years i consulted a doctor a long time ago the doctor told me that it is normal please help me ### Response: hi if it is small and if it is not causing pain or any other symptoms then there is no need to worry please send the images of it to guide you further

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: after unsafe exposure i got days elisa antibody test done days hiv proviral dna pcr test days elisa antibody test all were negative the antibody test i took is not a fourth generation test is it conclusive or should i take another test if i repeat the hiv test after six months what is the chance of staying negative i am facing the problem like small bumps in the tongue from the last two days a little bit of pain below ear region and it is a little swollen is it due to hiv i am stressed scared full of tension these are hampering my life i do not know what to do today i am in the day of exposure ### Response: hi your tests are conclusive and you are not infected no need for further tests ear ache and tongue papilla are not due to hiv and may be a simple bacterial infection consult ent specialist for an examination to rule out otitis externa you will remain negative even after six months and oneyear post exposure and no need for further testing weight loss may be a stressrelated issue just leave this hiv issue here and you will regain weight soon take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old and i wear contact lenses i have never really taken them off i would sleep with the contact lenses in my eyes and i have started wearing them since i was years old i would change them but i would not take them off and i would go days my vision gets worse when i go to the eye doctor but i have not had problems with infections recently i noticed that my left eye is red without pain or irritation but red as the color of the pink eye i do not know if it is the contact lenses which is causing the redness please help ### Response: it can be an infection but one thing you must remember is contact lenses should ideally be used to hours a day if you wear during sleep and for more than hours a day there is a possibility of the eyes developing infection and transparency of cornea getting decreased over a long time you must stop wearing contact lenses till your eyes are clear start wearing spectacles contact lenses related bacterial conjunctivitis or corneal hypoxia detailed slit lamp examination

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: while working out today i was doing a shoulder press i was doing it too fast and at one point i got a sharp pain in my back near where my ribs meet my spine since then i am also having very sharp pain when inhaling and exhaling as well as when rotating my torso or neck should i need to go for urgent care currently i am taking zyrtec amino acid supplements for energy and muscle recovery hormonal iud ### Response: hi it looks like you have muscle spasm or strain you can use overthecounter motrin mg ibuprofen twice or thrice a day with the meal for two to three days and there are topical analgesics available for the gentle massage it will get better within two to three days if it does not get relieved you can see your doctor take rest from the shoulder exercise for a week get immediate help if you feel that this pain is significantly disturbing breathing activity for more information consult an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am years old i have seen my period in the second month of last year and miss it up for a further two months i have seen it again after three months and stopped at the end of that month but anytime i have sexual intercourse i will bleed and past lots of blood clots for at least three days and then stop and i waited for four days i was good until i had sex again the same bleeding occurs and there was lots of blood clot please help ### Response: as there is oligomenorrhoea and your menses have returned after a long time eight months now it is essential that the cause needs to be investigated you need to get a complete hormonal profile with serum estradiol and serum testosterone levels with ultrasound pelvis to look for ovarian cysts pcos the bleeding post intercourse is likely due to cervical erosions which can cause bleeding and hence a per speculum exam with a pap smear is necessary as well the ultrasound can deduce the endometrial thickness and if thick then an endometrial biopsy may also be taken for histopathological examination and learning the phase of the endometrium in the meantime you should be placed on antifibrinolytics like tranexamic acid for controlling heavy bleeding obesity itself is a part of insulin resistance in pcos which can cause ovulation and hence delayed menses often please review with reports for further discussion and advice

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have an astigmatism of od os the last week i have had constant headaches and periodic blurry vision i am wondering if this could be a result of not wearing my glasses how often should i be wearing my glasses the periodic blurry vision started two weeks ago and one week ago the constant headache started to out of i have seen a few different doctors about it but they are not sure ### Response: firstly since how long time you put your glasses however there are many points i would like to explain to you for this my answer is yes your problem which you complain maybe caused because you do not put your glasses i advise you to use them as i told you and then if the problem is still there it is another speech for more information consult an eye care ophthalmologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: my upper front tooth with root canal has moved inside because of an injury and it is bleeding ### Response: hello if it is just pushed inside or back due to falling and is not mobile either go to a dentist soon and ask him if he can position it urgently a clear picture would have helped in giving an exact treatment plan nothing else can be done for now allow the wound to heal apply ice for one hour at least take some painkillers for three days try to eat liquid or semisolid food so as the tooth gets time to heal later after two weeks or so you can get a new crown made over the teeth

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: two years before i got tested my whole body and blood there are some dark circles that appear on my body and i am getting treated regularly but still my blood has some problem i get pt and inr tests done regularly ### Response: i understand from your post that you may have a blood clotting tendency have you ever had pain or swelling in your calf muscle and difficulty breathing you may be prone to blood clots in your lungs which is called pulmonary embolism so if you ever experience symptoms such as pain or swelling in your calf difficulty or shortness of breath or chest pain you must seek immediate medical help and go to emergency it would be helpful to know a bit more about your symptoms and your general health now

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i feel pain after eating some food around the belly button sometimes it feels warm also around belly button and itching as well and tastes come from mouth what i ate so i want to know what is happeing with me ### Response: hello you may be suffering from acute gastritis with acid reflux pain around the belly button may be due to small bowel infection or belly button pain until examination is done it is difficult to say what it is use tablet nexium mg before breakfast for one week avoid spicy food and alcohol consumption if symptoms are not improved please consult your doctor he will examine and treat you accordingly take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i had kissed a prostitute on lips and breast but did not have intercourse with her i have no cut on lips and mouth is there any chance of me getting any sti ### Response: hi it is really great that you want to know about an important issue and just do not want to make assumptions on your own stis are the diseases that are typically transmitted during sexual intercourse it is unlikely to catch sexually transmitted infections with kissing alone but with a few exceptions if the sti has manifested itself orally andor in oral fluid of that person hepatitis b virus can be transmitted through kissing as the virus is found in saliva and other body secretions of hbv infected person herpes infection this can be transmitted through kissing with a person who has a visible cold sore human papillomavirus hpv or warts and syphilis are less likely to be transmitted through kissing so far there is no reported case of hiv transmission through kissing take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have spastic paraplegia everything i have tried has not worked i was told to try a medication called ldopa will this medication help me ### Response: it will help you in spastic paraplegia in case there is a deficiency of dopamine in substantia niagra of your brain it is definitely going to help you if there is any deficiency but if there is no deficiency it will be of no help in my clinical experience baclofen helps mostly in resistant cases

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am a i am in height lbs weight my dad is and my mom is i would like to at least reach to my diet is exceptional i am taking a multivitamin and i do not have any deficiencies i am thinking of taking mg of glucosamine because i read studies concluding that it may help a bit would you recommend glucosamine or something elsealso do you think i can still reach my height goal i am worried that i may have stunted my growth i have had insomnia depression and anxiety for four years now this has affected my life considerably and i am worried i would not grow to my potential height because of it i also have not been getting too much calcium and protein because i have been avoiding dairy products should i be drinking more milk and if so how much ### Response: hello your average expected height is close to best way to help increase height is doing stretching exercises three to four times a week for minutes in a minutes session you can try glucosamine for a year but if it is not helping then taking it beyond that may not help you can try protein shakes calcium to mgd and vitamin d to iud supplements to avoid the deficiencies i hope it helps

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am having back pain near the spine on the right side especially when i go downstairs or go for a walk my back gets locked when i am standing still there is too much pain on the right side while sitting on a hard surface there is also nerve pain after having food sitting on the ground there is pain only on the right side while using the commode i am suffering from this pain from the past two years and have not got any relief kindly help me ### Response: i have gone through your reports attachments removed to protect patient identity i would like to know a few more details regarding the characteristics of pain and previous history revert back with the answers to the above questions to a spine surgeon online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have an odd thing happening in my left eye i see a flash of light when i look right to left in the left side of my eye it is a curve from top to bottom it happens in daylight nighttime and even in the dark with my eyes closed i move my pupil left to right and see a bright arc of light i can not make it stay there it just flashes as i move my eye balls left to right any ideas ### Response: hello this occurrence of flashes of light can be due to various causes the first and the most probable cause could be posterior vitreous detachment this is a benign condition not requiring any treatment here you may experience some floaters but no reduction in vision or nonseeing areas in your visual field the most important to rule out here would be the second condition retinal detachment here although you do experience floaters just like in posterior vitreous detachment the floaters are more numerous and keep increasing with time you will also have a reduction in vision with nonseeing areas in your visual field this often needs to be treated surgically i recommend you to visit an ophthalmologist in case there is no reduction of vision or increase in floaters i would not say that it is not urgent take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: hemoglobin platelets sgot sgpt and vitamin d all other reports are normal ### Response: hello you seem to be suffering from nonalcoholic fatty liver disease nafld this does not require any special treatment i suggest you avoid painkillers alcohol and reduce weight if you are obese i would also recommend you testing for hepatitis b and c i hope it helps you for more information consult a medical gastroenterologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i have not grown to the expected height i am cm my mother is cm and father is cm i had a blood test to determine my hgh levels the doctor asked me for a testosterone and gh test the result came back a week later and it said that i had a low hgh level and a level testosterone is this normal for an year old male i was devastated that my growth plates were closed because i also had an xray of left hand my doctor asked me whether i am sexually active i answered him no but i got a doubt regarding erectile dysfunction am i suffering from erectile dysfunction should i be worried is my testosterone too low how can i increase testosterone i had torsion three years back and nothing back happened but this could be a factor another factor may be that i used to hold my mobile phone in my pocket all the timei am a sprint athlete and have defined leg muscles but this could be due to my short stature i have gone for another blood test for gh just as a follow up and that time i was advised to fast for hours but i did not fast during my first blood test please help me ### Response: please relax and do not worry free and total serum fsh and lh ultrasound examination of your scrotum to look for the status of your testes

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am six days post operative from a full tummy tuck with liposuction and muscle repair i feel that i am recovering normally from what i was told and what i read however the area immediately above my belly button is extremely sore and appears to almost be bulging and is slightly elevated when touched i did have my follow up and questioned this area and he cited the muscle repair and the liposuction but i wanted to get a second opinion on this and see if anyone has had similar experiences that are normal ### Response: i have gone through your post it is expected because some amount of hematoma is expected at the site of muscle repair and should not be a reason for worry you need to keep watch on fever in case there is a fever that has to be treated because that may be due to infection of the site for more information consult an internal medicine physician online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am an and i have experienced forgetfulness ever since i was in elementary i usually ace my tests because i have a very short term memory so cramming often makes do but i often tend to forget things when my body takes the socalled autopilot mode during these times i tend to do things with me not really focusing on doing it because i was thinking of something else i can not really recall what exactly happened in a day when nothing special has occurred i often forget where i put things even when they are already in front of me or in my hand i seem to misplace habitually and it has pertrubed my parents now i am wandering if these are early symptoms of alzheimers please reply and if you want to ask questions about mefeel free ### Response: hello i understand your concern and would explain that your symptoms are not related to dementia or alzheimer at your age considering the description of your complaints i would think about a concentration disorder attention disorder this could be related to adhd or anxiety for this reason i would recommend consulting with a psychiatrist or psychologist to help determine the right cause it is also important checking complete blood count for anemia and thyroid hormone levels for thyroid gland dysfunction take care

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: five years ago my mother was diagnosed with fibromyalgia i think she also has rheumatoid arthritis for the past five years she was managing the pain with antiinflammatory medicine lyrica mythycobal voltaren injections herbal creams etc you can see the veins in her hands popping out i also realized that the pain has got worse nowfor about months the doctor put her only on prednisolone mgday and painkiller when necessary she was fine till last month but the pain increased in her hands now in the daytime she is fine and the pain starts mildly in the evening when she lies down in the bed she gets electrical tingling in her legs by which her sleep gets disturbed she has undergone several tests last week and i attached them for your reference she did not consult a rheumatologist yet what medication can i give to reduce the inflammation and cure her her esr cpr and ana are quite high the pain in her hands and the tingling in her legs at night are agonizing her life kindly provide your expert advice ### Response: first of all your mother does not have rheumatoid arthritis or fibromyalgia from her reports attachment removed to protect patient identity i found that she has connective tissue disorder and the most possible diagnosis would be systemic lupus erythematosus sle the joint pain high esr erythrocyte sedimentation rate crp creactive protein positive ana antinuclear antibody and response to prednisolone favors the diagnosis of connective tissue disorder she definitely does not have functional pain which occurs in fibromyalgia her pain and suffering are very truenow to help you better i need some more details revert back with the answers for the above questions to a rheumatologist online

Below is an instruction that describes a task, paired with an input that provides further context. Write a response that appropriately completes the request. ### Instruction: If you are a doctor, please answer the medical questions based on the patient's description. ### Input: i am currently having acne on my cheeks i am currently applying benzoyl peroxide gel on my acne it only reduces the inflammation but bumps are not reducing i also have pigmentation caused by acne before i only get acne on my cheeks what may be the reason i usually get cyst acne bumps on my cheeks if acne clears then it comes again i have red pigmentation caused by acne can you recommend a product for acne and after acne has cleared can you suggest a product for pigmentation can you recommend a product for controlling further breakouts also i wanted to know which sunscreen and moisturizer to use ### Response: hi acne reduces in severity with aging use cleanser like cetaphil to wash face apply retinoa retinol cream in the night clindamycin gel in the morning you can use sunscreens like shade avobenzone oxybenzone lotion retinoa helps in pigmentation and to some extent scars you can consider lasers later if scars persist for more information consult a dermatologist online